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Remote Claim Reviewer Jobs in Washington (NOW HIRING)

C-MCI

Medical Billing Specialist

Fairfax, VA · On-site +1

$18.50 - $24/hr

Remote / On-site Department: Revenue Cycle Management Overview: CMCI is seeking a detail-oriented ... Accuratelyprocess, review, and submit medical claims. * Verify CPT,ICD-10, and HCPCS codes to ...

WearLinq

Medical Billing Associate

Rockville, MD · On-site +1

$44K/yr

Prepare, review, and submit professional and technical claims for cardiac diagnostic services in ... Monitor claim status, identify delays, and follow up with commercial payers, Medicare, and Medicaid ...

Deloitte

Epic Denials Management Operator

Rosslyn, VA · Remote

$20.50 - $27.25/hr

This is a primarily remote role supporting enterprise Epic support, with minimal travel and ... Review hospital account records and payer remittance records, communicate with relevant Client RCM ...

Deloitte

Epic Denials Management Operator

Washington, DC · Remote

$20.50 - $27.25/hr

This is a primarily remote role supporting enterprise Epic support, with minimal travel and ... Review hospital account records and payer remittance records, communicate with relevant Client RCM ...

Deloitte

Epic Denials Management Operator

Mclean, VA · Remote

$18.25 - $24.25/hr

This is a primarily remote role supporting enterprise Epic support, with minimal travel and ... Review hospital account records and payer remittance records, communicate with relevant Client RCM ...

Corvel

Senior Liability Claims Specialist

Rockville, MD · Remote

$61K - $98K/yr

Communicates claim status with the customer, claimant, and client * Adheres to client and carrier ... review as needed * Collaborates with team members on more complex or problematic claims as ...

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All JobsClaim Reviewer JobsRemote Claim Reviewer JobsRemote Claim Reviewer Jobs in Washington

Remote Claim Reviewer information

What is the difference between Remote Claim Reviewer vs Remote Claims Processor?

AspectRemote Claim ReviewerRemote Claims Processor
Required CredentialsHigh school diploma or equivalent; insurance knowledge often preferredHigh school diploma or equivalent; basic insurance or data entry skills
Work EnvironmentHome-based, independent review settingHome-based, processing claims and data entry
Industry UsageInsurance companies, third-party administratorsInsurance companies, healthcare providers
Common Search IntentComparing roles involving claim review and evaluationRoles focused on processing and data entry of claims

The main difference is that Remote Claim Reviewers evaluate and assess insurance claims for accuracy and validity, often requiring insurance knowledge. Remote Claims Processors handle the entry and processing of claims, focusing on data entry and administrative tasks. Both roles are remote and industry-specific but differ in responsibilities and skill requirements.

What are popular job titles related to Remote Claim Reviewer jobs in Washington?

For Remote Claim Reviewer jobs in Washington, the most frequently searched job titles are:

What job categories do people searching Remote Claim Reviewer jobs in Washington look for?

The top searched job categories for Remote Claim Reviewer jobs in Washington are:

Remote Claim Reviewer jobs near you

Senior Claims Representative - California Workers Compensation (Remote)

Berkley

Manassas, VA • Remote

$66K - $85K/yr

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago

Job description

Company Details

BerkleyNet is an innovative workers compensation insurance provider that does all of our business online. Our Goal? To make doing business "Ridiculously Fast. Amazingly Easy."

Responsibilities

As a Senior Claims Representative, you will be responsible for the investigation, evaluation, mitigation and resolution of an inventory of lost time and catastrophic workers' compensation injury claims in multiple jurisdictions.

  • Investigate workers' compensation claims by interviewing injured workers, witnesses, and policyholders to verify coverage and determine compensability and benefits due
  • Calculate and set timely financial reserves and proactively manage reserve adequacy throughout claim lifecycle
  • Record and code injured worker demographics, job information and accident information in company's claims management system and files necessary forms with state regulatory agencies
  • Issue timely payments to injured workers, medical providers and service vendors
  • Coordinate and actively manage medical treatment of injured workers to ensure timely rehabilitation
  • Negotiate settlements of claims within designated authority with injured workers and attorneys
  • Serve as the team's subject matter expert of the Workers' Compensation Act, adjudication process, and regulatory compliance framework in assigned jurisdictions
  • Identify and manage subrogation, Second Injury Fund and joint coverage recovery opportunities
  • Regularly communicate claim activity and status updates to policyholders, injured workers and other interested parties in a professional, thoughtful and tactful manner
  • Notify management and develop reports for large exposure claims and comply with reinsurance reporting requirements
  • Manage the claims litigation process to ensure timely and cost-effective claims resolution
  • Monitor the expenses and effectiveness of managed care and investigation vendors
  • Periodically travel to attend hearings, conferences and training sessions
  • Attend and participate in claim file reviews with management and defense attorneys
  • Coordinate and lead special projects or processes as assigned by management
  • Assists with oversight and supervisory duties when the team supervisor is unavailable or as assigned by supervisor
  • Support management with training and staff development
  • Support management with vendor management activities
  • Continuously strives to improve our product and business results through innovation
  • Obtain and maintain adjuster license(s) in assigned jurisdictions
Candidates with  California Workers' Compensation experience may be eligible for a remote work arrangement based on qualifications and business needs.Qualifications
  • 3 - 5 years of experience handling workers' compensation claims
  • Excellent written and verbal communication skills
  • Strong interpersonal and relationship building skills
  • Exceptional time management and organization skills
  • Strong analytical and critical thinking skills
  • Ability to work independently and strategically problem solve
  • Ability to diplomatically manage conflict
  • Ability to develop relationships within the organization and work effectively across departments
  • Strong discretion and integrity in dealing with highly confidential and sensitive information
  • Detail oriented

Education Requirement

  • Bachelors' degree or equivalent insurance industry work experience
  • AIC, ARM, CCP, or CPCU insurance designation preferred
Additional Company DetailsThe Company is an equal employment opportunity employer. We do not accept any unsolicited resumes from external recruiting firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. Base salary & Benefits include Health, dental, vision, life, disability, wellness, paid time off, 401(k) and profit-sharing plans. Salary Range: 75k - 110k The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.Employment Type: PART_TIME

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