Claims Adjudicator
Miami, FL · On-site
... contractual benefits and terms, and regulatory requirements. The claims adjudicator ensures that ... Reasonable accommodation may be made to enable individuals with disabilities to perform the ...
Miami, FL · On-site
... contractual benefits and terms, and regulatory requirements. The claims adjudicator ensures that ... Reasonable accommodation may be made to enable individuals with disabilities to perform the ...
Miami, FL · On-site
... contractual benefits and terms, and regulatory requirements. The claims adjudicator ensures that ... Reasonable accommodation may be made to enable individuals with disabilities to perform the ...
Miami, FL · On-site
... contractual benefits and terms, and regulatory requirements. The claims adjudicator ensures that ... Reasonable accommodation may be made to enable individuals with disabilities to perform the ...
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Miami, FL · On-site
... contractual benefits and terms, and regulatory requirements. The claims adjudicator ensures that ... Reasonable accommodation may be made to enable individuals with disabilities to perform the ...
Miami, FL · On-site
... contractual benefits and terms, and regulatory requirements. The claims adjudicator ensures that ... Reasonable accommodation may be made to enable individuals with disabilities to perform the ...
Quick apply
Miami, FL · On-site
... contractual benefits and terms, and regulatory requirements. The claims adjudicator ensures that ... Reasonable accommodation may be made to enable individuals with disabilities to perform the ...
Peachtree Corners, GA · On-site +1
$37K - $68K/yr
Applies the appropriate contractual provisions; case management resources; and claim processes to ... Bachelor's degree or equivalent experience required. * 2 + years of STD/LTD claims adjudication
Peachtree Corners, GA · On-site +1
$37K - $68K/yr
Applies the appropriate contractual provisions; case management resources; and claim processes to ... Bachelor's degree or equivalent experience required. * 2 + years of STD/LTD claims adjudication
Peachtree Corners, GA · On-site +1
$37K - $68K/yr
Applies the appropriate contractual provisions; case management resources; and claim processes to ... Bachelor's degree or equivalent experience required. * 2 + years of STD/LTD claims adjudication
Peachtree Corners, GA · On-site +1
$37K - $68K/yr
Applies the appropriate contractual provisions; case management resources; and claim processes to ... Bachelor's degree or equivalent experience required. * 2 + years of STD/LTD claims adjudication
Bachelor's degree or equivalent experience required. * 2 + years of STD/LTD claims adjudication ... Applies the appropriate contractual provisions; case management resources; and claim processes to ...
Bachelor's degree or equivalent experience required. * 2 + years of STD/LTD claims adjudication ... Applies the appropriate contractual provisions; case management resources; and claim processes to ...
Bachelor's degree or equivalent experience required. * 2 + years of STD/LTD claims adjudication ... Applies the appropriate contractual provisions; case management resources; and claim processes to ...
Bachelor's degree or equivalent experience required. * 2 + years of STD/LTD claims adjudication ... Applies the appropriate contractual provisions; case management resources; and claim processes to ...
Bachelor's degree or equivalent experience required. * 2 + years of STD/LTD claims adjudication ... Applies the appropriate contractual provisions; case management resources; and claim processes to ...
Bachelor's degree or equivalent experience required. * 2 + years of STD/LTD claims adjudication ... Applies the appropriate contractual provisions; case management resources; and claim processes to ...
Dallas, TX · On-site
$17 - $18.50/hr
... to our contractual agreements and UT Southwestern policy. This includes timely processing of ... and adjudication status within established timeframes. Display competent ability to access ...
Dallas, TX · On-site
$17 - $18.50/hr
... to our contractual agreements and UT Southwestern policy. This includes timely processing of ... and adjudication status within established timeframes. Display competent ability to access ...
$17 - $18.50/hr
... to our contractual agreements and UT Southwestern policy. This includes timely processing of ... and adjudication status within established timeframes. Display competent ability to access ...
$17 - $18.50/hr
... to our contractual agreements and UT Southwestern policy. This includes timely processing of ... and adjudication status within established timeframes. Display competent ability to access ...
Philadelphia, PA · On-site
Analyze pricing discrepancies and perform adjustments to align with contractual and system ... Validate contract terms and ensure proper interpretation within claims adjudication systems
Philadelphia, PA · On-site
Analyze pricing discrepancies and perform adjustments to align with contractual and system ... Validate contract terms and ensure proper interpretation within claims adjudication systems
$144K - $238K/yr
Direct all aspects of claims intake, adjudication, payment, adjustment, and provider reimbursement ... Ensure claims are processed accurately, timely, and in compliance with contractual, regulatory, and ...
New
$144K - $238K/yr
Direct all aspects of claims intake, adjudication, payment, adjustment, and provider reimbursement ... Ensure claims are processed accurately, timely, and in compliance with contractual, regulatory, and ...
New
California, MD · Remote
$144K - $238K/yr
Direct all aspects of claims intake, adjudication, payment, adjustment, and provider reimbursement ... Ensure claims are processed accurately, timely, and in compliance with contractual, regulatory, and ...
New
California, MD · Remote
$144K - $238K/yr
Direct all aspects of claims intake, adjudication, payment, adjustment, and provider reimbursement ... Ensure claims are processed accurately, timely, and in compliance with contractual, regulatory, and ...
New
Nevada, IA · Remote
$144K - $238K/yr
Direct all aspects of claims intake, adjudication, payment, adjustment, and provider reimbursement ... Ensure claims are processed accurately, timely, and in compliance with contractual, regulatory, and ...
New
Nevada, IA · Remote
$144K - $238K/yr
Direct all aspects of claims intake, adjudication, payment, adjustment, and provider reimbursement ... Ensure claims are processed accurately, timely, and in compliance with contractual, regulatory, and ...
New
Manhattan, NY · On-site
$30 - $33/hr
Evaluate and resolve claims pended due to contractual or payment discrepancies. Generate provider ... Adjudication Payment Discrepancy Resolution Quality Assurance Time Management Problem Solving ...
New
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Manhattan, NY · On-site
$30 - $33/hr
Evaluate and resolve claims pended due to contractual or payment discrepancies. Generate provider ... Adjudication Payment Discrepancy Resolution Quality Assurance Time Management Problem Solving ...
New
Golden, CO · On-site +1
$150K - $180K/yr
Contractual Oversight: Reviewing contract terms (e.g., FIDIC, NEC, JCT) to identify entitlements ... Dispute Resolution (ADR) processes, including mediation, adjudication, and arbitration.
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Golden, CO · On-site +1
$150K - $180K/yr
Contractual Oversight: Reviewing contract terms (e.g., FIDIC, NEC, JCT) to identify entitlements ... Dispute Resolution (ADR) processes, including mediation, adjudication, and arbitration.
Manhattan, NY · On-site
$30 - $33/hr
Evaluate and resolve claims pended due to contractual or payment discrepancies. Generate provider ... Adjudication Payment Discrepancy Resolution Quality Assurance Time Management Problem Solving ...
New
Manhattan, NY · On-site
$30 - $33/hr
Evaluate and resolve claims pended due to contractual or payment discrepancies. Generate provider ... Adjudication Payment Discrepancy Resolution Quality Assurance Time Management Problem Solving ...
New
New York, NY · On-site
$71K - $87K/yr
Position Summary Manage claims adjudication by identifying contractual variances between posted and ... disability, domestic violence victim status, ethnicity, familial status, gender and/or gender ...
New York, NY · On-site
$71K - $87K/yr
Position Summary Manage claims adjudication by identifying contractual variances between posted and ... disability, domestic violence victim status, ethnicity, familial status, gender and/or gender ...
$71K - $87K/yr
Manage claims adjudication by identifying contractual variances between posted and expected ... disability, domestic violence victim status, ethnicity, familial status, gender and/or gender ...
$71K - $87K/yr
Manage claims adjudication by identifying contractual variances between posted and expected ... disability, domestic violence victim status, ethnicity, familial status, gender and/or gender ...
Ensure full compliance with client standards, contractual deliverables, and established Key ... Ability to obtain and maintain a client specific adjudication. * Knowledge of security operations ...
Ensure full compliance with client standards, contractual deliverables, and established Key ... Ability to obtain and maintain a client specific adjudication. * Knowledge of security operations ...
$32K - $37.5K
7% of jobs
$37.5K - $43.1K
7% of jobs
$48.5K is the 25th percentile. Wages below this are outliers.
$43.1K - $48.6K
11% of jobs
$48.6K - $54.2K
11% of jobs
$54.2K - $59.7K
12% of jobs
The median wage is $60.7K / yr.
$59.7K - $65.3K
15% of jobs
$69.5K is the 75th percentile. Wages above this are outliers.
$65.3K - $70.8K
17% of jobs
$70.8K - $76.4K
13% of jobs
$76.4K - $81.9K
7% of jobs
$81.9K - $87.5K
1% of jobs
$87.5K - $93K
0% of jobs
$32K
$61.9K
$93K
Other
Medical
Re-posted 3 days ago
The Claims Adjudicator is responsible for reviewing, analyzing, and processing health insurance claims in accordance with established guidelines, contractual benefits and terms, and regulatory requirements. The claims adjudicator ensures that all claims are handled accurately, efficiently, and within specified timeframes, contributing to the overall effectiveness of the claims processing team. This role requires a detailed-oriented professional with a strong ability to follow instructions and a proactive approach to identifying and resolving discrepancies.
Essential FunctionsThe following job-related working conditions are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function.
Work EnvironmentThe role primarily operates in an in-door, climate-controlled office setting working in close proximity to others. Noise level in the work environment is low to moderate. Light level provides adequate brightness for reading, computer work, and other tasks without causing glare or strain.
Physical DemandsThe job primarily involves sedentary work with prolonged periods sitting at a desk. While performing the duties of this job, employees may occasionally be expected to:
Minimal to no travel required