Adjuster, Claims - Remote

Molina Healthcare; Chicago (IL); Remote; USD 80,000 - 100,000; Full time

Job summary

A healthcare provider based in Chicago is seeking a Claims Administrator responsible for managing claims payments and maintaining records. The role requires strong interpersonal skills and the ability to work collaboratively. Ideal candidates will have an Associate's degree and 1-3 years of relevant experience. The position offers a pay range of $21.16 - $31.71 per hour, along with a competitive benefits package.

Qualifications

• 1-3 years of experience in claims processing required.
• 3-5 years of experience preferred.
• Ability to handle basic projects as assigned.

Responsibilities

• Administer claims payments and maintain claim records.
• Ensure timely claims settlement according to standards.
• Assist in defect reduction communicated to management.

Skills

Researching tracers

Error issue communication

Interpersonal skills

Teamwork

Education

Associate degree or equivalent

Bachelor's Degree or equivalent

Job description

JOB DESCRIPTION

Job Summary

Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.

KNOWLEDGE/SKILLS/ABILITIES

• Researches tracers, adjustments, and re-submissions.
• Handles basic projects as assigned.
• Assists with defect reduction by identifying and communicating error issues and potential solutions to management.
• Helps to improve overall performance accountability (attendance, communication, flexibility, adaptability, interpersonal skills, teamwork and cooperation).
• Adjudicates or re-adjudicate claims in a timely manner to ensure compliance to departmental turn-around time and quality standards.
• Meets department quality and production standards.
• Other duties as assigned.

JOB QUALIFICATIONS

Required Education

Associate degree or equivalent combination of education and experience

Required Experience

1-3 Years

Preferred Education

Bachelor's Degree or equivalent combination of education and experience

Preferred Experience

3-5 years

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $21.16 - $31.71 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.