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Medicaid Claims Processing Remote Jobs in Colorado

Risk Claims Manager

Denver, CO ยท Remote

$85K - $95K/yr

This position has the potential to be remote. ESSENTIAL JOB DUTIES * Personally investigate and ... Knowledge of statistical process control desirable.

Senior Analytics Engineer

Wheat Ridge, CO ยท On-site +1

$94K - $116K/hr

This position can be fully remote, although occasional onsite work may be required. Essential ... Experience with behavioral health, Medicaid, claims, or value-based care preferred. Core Technical ...

This position investigates and adjusts claims, as well as directs defense counsel, independent adjusters, experts, and other vendors in the claims-handling processes. Requirements * Bachelor's degree ...

Sr. Injury Claims Adjuster

Colorado Springs, CO ยท On-site +1

$63K - $121K/yr

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Clearly documents thought process, investigation, evaluation, negotiation, and settlement decisions.

Sr. Injury Claims Adjuster

Colorado Springs, CO ยท On-site +1

$63K - $121K/yr

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Clearly documents thought process, investigation, evaluation, negotiation, and settlement decisions.

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Medicaid Claims Processing Remote information

What is Medicaid claims processing remote?

Medicaid Claims Processing Remote refers to the job of reviewing, analyzing, and processing Medicaid insurance claims from a location outside of a traditional office, often from home. Professionals in this role ensure that claims are accurate, complete, and comply with Medicaid regulations before approving or denying payment. Remote workers use specialized software to access claim information securely and may communicate with healthcare providers and patients to gather additional details. This job requires attention to detail, knowledge of Medicaid policies, and the ability to work independently. Remote claims processors play a crucial role in ensuring the timely and accurate reimbursement of healthcare services for Medicaid recipients.

What are the key skills and qualifications needed to thrive as a Medicaid claims processing remote professional?

To thrive in a Medicaid Claims Processing Remote role, you need a solid understanding of medical billing, coding, and Medicaid regulations, typically supported by experience in healthcare administration or claims processing. Familiarity with claims management software, medical coding systems (such as ICD-10 or CPT), and electronic data interchange (EDI) platforms is essential. Strong attention to detail, organizational skills, and effective communication are crucial soft skills for accuracy and collaboration. These skills ensure timely and accurate processing of claims, compliance with regulations, and effective resolution of claim issues in a remote environment.

What are some common challenges faced in a remote Medicaid claims processing position, and how can they be managed?

Working remotely as a Medicaid Claims Processor can present challenges such as staying up-to-date with changing regulations, maintaining attention to detail when reviewing large volumes of claims, and ensuring secure handling of sensitive patient data. To manage these challenges, it's important to regularly participate in team training sessions, utilize checklists or claim management software to minimize errors, and follow strict data security protocols. Open communication with supervisors and colleagues through virtual platforms also helps in resolving complex claims and staying connected with team goals.

What are the most commonly searched types of Medicaid Claims Processing jobs in Colorado?

The most popular types of Medicaid Claims Processing jobs in Colorado are:

What cities in Colorado are hiring for Medicaid Claims Processing Remote jobs?

Cities in Colorado with the most Medicaid Claims Processing Remote job openings:

Manager, Claims Operations - Property Claims

USAA Careers

Colorado Springs, CO โ€ข On-site, Remote

$103K - $186K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago


Job description

Why USAA?

At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.

Embrace a fulfilling career at USAA, where our core values โ€“ honesty, integrity, loyalty and service โ€“ define how we treat each other and our members. Be part of what truly makes us special and impactful.

We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs.

The Opportunity

We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the following locations: San Antonio, TX, Phoenix, AZ, Colorado Springs, CO, Tampa, FL or Chesapeake, VA. Relocation assistance is not available for this position.

Manages and is accountable for property, and other claims operations member service employees who are responsible for serving our members, and providing appropriate solutions as they investigate, evaluate and negotiate the claim. Develop engaged employees through regular coaching and feedback to deliver business results. Execute process improvements, provides feedback on the process and leads organizational process changes. Drives execution of operational risk management, regulatory compliance training, policies and procedures.

What you'll do:

  • Inspects and reviews quality of property claim files and provide feedback to employees as appropriate.

  • Responsible for ongoing coaching and driving awareness so employees understand how their work and contributions support the overall claims and Enterprise strategies.

  • Proactively identifies opportunities to improve operational effectiveness, member experiences and processes providing feedback to internal partners.

  • Creating conditions for success removes obstacles, leads and champions change.

  • Achieves optimal productivity through managing workload volumes, staffing, training needs, and identifying and implementing appropriate solutions.

  • Responsible for ongoing monitoring of work to ensure consistent execution of processes and adherence to guidelines and frameworks.

  • Handles escalations and makes appropriate decisions based on the policy.

  • Facilitates and guides employees through skill identification and developing for career progression Supports projects by serving as a subject matter expert.

  • Hires, develops, and coaches claims employees for results delivery.

  • Consistently coaches employees on claims handling and identifies opportunities to improve overall process and engagement.

  • Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

What you have:

  • Bachelor's degree OR 4 years of relevant education and/or experience.

  • 6 years of progressive customer service, operational, military or leadership experience to include a minimum of 2 years of claims handling experience required with demonstrated proficiency.

  • 2 years of direct team lead, supervisory or management experience.

  • Experience using and interpreting data to make decisions.

  • Demonstrated leadership, initiative, customer service and/or claims handling skills.

  • Acquisition and maintenance of applicable insurance adjuster license within 6 months time in role.

What sets you apart:

  • 5 years of property claims experience handling moderate severity Homeowners or Dwelling claims.

  • Experience handling water loss claims.

  • Knowledge of property claims contracts and interpretation of case law.

  • Residential construction experience.

  • Knowledge of Xactimate, XactAnalysis and XactContents.

  • Experience handling catastrophe claims.

  • CPCU or other insurance industry designation.

  • Current or prior L4A participant.

  • US military experience gained through military service or gained as a military spouse / domestic partner.

Compensation range: The salary range for this position is: $103,450 - $186,210.

USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).

Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.

Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.

The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.

Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.

For more details on our outstanding benefits, visit our benefits page on USAAjobs.com.

Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.

 

USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.