Columbia, MD · On-site
$52.96/hr
Healthcare EDI Claims Analyst Location: Hybrid - Columbia/Baltimore, MD (2-3 days onsite per month ... Support claims adjudication and vouchering processes. * Document incidents, resolutions, and ...
Quick apply
Columbia, MD · On-site
$52.96/hr
Healthcare EDI Claims Analyst Location: Hybrid - Columbia/Baltimore, MD (2-3 days onsite per month ... Support claims adjudication and vouchering processes. * Document incidents, resolutions, and ...
Charlotte, NC · On-site
$82K - $103K/yr
At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we ... Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims ...
Charlotte, NC · On-site
$82K - $103K/yr
At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we ... Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims ...
Charlotte, NC · On-site
$82K - $103K/yr
At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we ... Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims ...
Charlotte, NC · On-site
$82K - $103K/yr
At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we ... Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims ...
Whittier, CA · On-site
$31 - $32/hr
Healthcare Claims Examiner Location: Whittier, CA Shift: Monday - Friday | 7:00 AM - 3:30 PM ... Minimum 2 years of claims adjudication experience in an ambulatory, hospital, HMO, or IPA ...
Quick apply
Whittier, CA · On-site
$31 - $32/hr
Healthcare Claims Examiner Location: Whittier, CA Shift: Monday - Friday | 7:00 AM - 3:30 PM ... Minimum 2 years of claims adjudication experience in an ambulatory, hospital, HMO, or IPA ...
Charlotte, NC · Hybrid
$17.25 - $23.50/hr
Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims ... Provide support to Customer Care representatives in relation to claims and benefits questions from ...
Charlotte, NC · Hybrid
$17.25 - $23.50/hr
Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims ... Provide support to Customer Care representatives in relation to claims and benefits questions from ...
Tulsa, OK · On-site
$20/hr
Healthcare Claims Project Specialist - Contract Downtown Tulsa | $20/hour | Immediate Start ... Check claims adjudication for accuracy * Identify and document system issues * Help troubleshoot ...
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Tulsa, OK · On-site
$20/hr
Healthcare Claims Project Specialist - Contract Downtown Tulsa | $20/hour | Immediate Start ... Check claims adjudication for accuracy * Identify and document system issues * Help troubleshoot ...
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Quick apply
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Quick apply
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Quick apply
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Quick apply
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Quick apply
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Quick apply
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Quick apply
Tulsa, OK · On-site
$18 - $20/hr
Healthcare Claims Specialist (CONTRACT Opportunity) Downtown Tulsa, OK Monday-Friday | 8:00 AM - 5 ... Verify claims adjudication accuracy and provider contract configurations. * Identify, document, and ...
Burlingame, CA · On-site
$112K - $128K/yr
This role provides guidance on healthcare claims adjudication and payment processing for Medi-Cal, Medicare, PACE, and other lines of business based on member Evidence of Coverages (EOC) and CMS/DHCS ...
Burlingame, CA · On-site
$112K - $128K/yr
This role provides guidance on healthcare claims adjudication and payment processing for Medi-Cal, Medicare, PACE, and other lines of business based on member Evidence of Coverages (EOC) and CMS/DHCS ...
San Antonio, TX · On-site
Previous healthcare claims or claims adjudication experience preferred. Experience in healthcare administration or claims operations is a plus. Required Skills & Experience Basic understanding of ...
San Antonio, TX · On-site
Previous healthcare claims or claims adjudication experience preferred. Experience in healthcare administration or claims operations is a plus. Required Skills & Experience Basic understanding of ...
Burlingame, CA · On-site
This role provides guidance on healthcare claims adjudication and payment processing for Medi-Cal, Medicare, PACE, and other lines of business based on member Evidence of Coverages (EOC) and CMS/DHCS ...
Burlingame, CA · On-site
This role provides guidance on healthcare claims adjudication and payment processing for Medi-Cal, Medicare, PACE, and other lines of business based on member Evidence of Coverages (EOC) and CMS/DHCS ...
Burlingame, CA · On-site
This role provides guidance on healthcare claims adjudication and payment processing for Medi-Cal, Medicare, PACE, and other lines of business based on member Evidence of Coverages (EOC) and CMS/DHCS ...
Burlingame, CA · On-site
This role provides guidance on healthcare claims adjudication and payment processing for Medi-Cal, Medicare, PACE, and other lines of business based on member Evidence of Coverages (EOC) and CMS/DHCS ...
Smyrna, GA · On-site
$22/hr
JOIN A LEADING HEALTHCARE COMPANY Do you dream of a great career with a great company - where you ... Curant Curant Health is searching for a Claims Adjudication Coordinator to join its team in Smyrna ...
Smyrna, GA · On-site
$22/hr
JOIN A LEADING HEALTHCARE COMPANY Do you dream of a great career with a great company - where you ... Curant Curant Health is searching for a Claims Adjudication Coordinator to join its team in Smyrna ...
Frisco, TX · On-site
$90 - $130/hr
... healthcare administration, insurance, or revenue cycle management * Strong understanding of claims adjudication, reimbursement methodologies, and payment integrity principles * Experience performing ...
Frisco, TX · On-site
$90 - $130/hr
... healthcare administration, insurance, or revenue cycle management * Strong understanding of claims adjudication, reimbursement methodologies, and payment integrity principles * Experience performing ...
Frisco, TX · On-site
... healthcare administration, insurance, or revenue cycle management * Strong understanding of claims adjudication, reimbursement methodologies, and payment integrity principles * Experience performing ...
Frisco, TX · On-site
... healthcare administration, insurance, or revenue cycle management * Strong understanding of claims adjudication, reimbursement methodologies, and payment integrity principles * Experience performing ...
$15.14 - $16.24
7% of jobs
$16.24 - $17.33
13% of jobs
$18.07 is the 25th percentile. Wages below this are outliers.
$17.33 - $18.42
7% of jobs
$18.42 - $19.51
7% of jobs
$19.51 - $20.61
9% of jobs
The median wage is $20.94 / hr.
$20.61 - $21.70
19% of jobs
$21.70 - $22.79
9% of jobs
$23.02 is the 75th percentile. Wages above this are outliers.
$22.79 - $23.89
12% of jobs
$23.89 - $24.98
9% of jobs
$24.98 - $26.07
3% of jobs
$26.07 - $27.16
3% of jobs
$15
$21
$27
A Healthcare Claims Adjudication job involves reviewing and processing medical insurance claims to determine their validity, accuracy, and coverage under a policy. Adjudicators analyze medical codes, policy guidelines, and patient information to approve, deny, or request further details on claims. They ensure compliance with insurance regulations and detect possible fraud or errors. The role requires attention to detail, knowledge of healthcare billing, and proficiency with claims processing systems to maintain efficiency and accuracy.
To thrive in Healthcare Claims Adjudication, you need a strong understanding of medical terminology, insurance policies, and claims processing procedures, typically backed by a high school diploma or associate degree. Familiarity with claims management software (such as Facets or AMISYS), ICD-10 and CPT coding, and HIPAA regulations is often required. Attention to detail, critical thinking skills, and effective communication set top adjudicators apart. These abilities are vital to ensuring accurate claims resolution, compliance with regulations, and positive relationships with providers and policyholders.
Professionals in Healthcare Claims Adjudication frequently encounter challenges such as interpreting complex policy terms, handling high volumes of claims, and ensuring accuracy while meeting tight deadlines. Adjudicators must also stay alert to potential fraud, inconsistencies, and ever-evolving industry regulations. These roles often require collaboration with other departments, such as customer service and medical review teams, to resolve discrepancies quickly. Successfully managing these challenges is essential for upholding operational efficiency, customer satisfaction, and regulatory compliance.
Cities with the most Healthcare Claims Adjudication job openings:
The most popular types of Healthcare Claims Adjudication jobs are:
States with the most job openings for Healthcare Claims Adjudication jobs include:
The top searched job categories for Healthcare Claims Adjudication jobs are:
$52.96/hr
Contractor
Medical, PTO
Re-posted 13 days ago
Healthcare EDI Claims Analyst
Location: Hybrid – Columbia/Baltimore, MD (2-3 days onsite per month) Duration: 12-Month Contract-to-Hire Pay Rate: $52.96/hour W2 (No PTO)
About the Role
We are seeking a Healthcare EDI Claims Analyst to support healthcare claims processing operations. This role focuses on investigating claims issues, resolving incident tickets, analyzing EDI transactions, and coordinating with internal teams and health plans to ensure successful claims processing.
This is an operational support and claims analysis position—not a software development, production support, or monitoring role.
Responsibilities
Required Qualifications
Preferred Qualifications
Ideal Background
Candidates with experience in the following roles are encouraged to apply:
What We're Looking For
A healthcare claims professional who enjoys investigating issues, resolving claims-related incidents, working with EDI transactions, and collaborating across teams to drive successful outcomes. This is a hands-on role focused on claims operations and issue resolution rather than software development.
Apply today to join a team supporting critical healthcare claims processing operations.
Ref: #851-Rockville-S1
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System One helps employers get work done more efficiently and economically without compromising quality. Over our 35+ year history, we've helped connect thousands of talented people with innovative companies. The excitement of a perfect fit motivates us every single day.
Business consulting services and recruiting and staffing services
5,001 - 10,000 Employees
Pittsburgh, PA, US
