Claims Adjuster

KORAK GLOBAL HEALTHCARE SERVICES LLC; Maryland; A distancia; USD 23.000 - 50.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

100% Remote Work

Stability: Full-time hours with a defined 1-year contract

Training Provided

Descripción de la vacante

KORAK GLOBAL HEALTHCARE SERVICES is seeking a motivated Claims Adjuster for a fully remote position on a 1-year full-time contract. Candidates must have a high school diploma and at least 5 years of claims adjustment experience. This role involves investigating claims, maintaining documentation, and ensuring compliance with protocols while maintaining customer service excellence.

Formación

• Minimum 5 years of hands-on claims adjustment experience.
• Solid understanding of claims systems, policies, and procedures.
• Comfortable interacting with challenging customers.

Responsabilidades

• Investigate and adjust claims according to policies.
• Maintain accurate documentation of claims activity.
• Approve or deny claims based on judgment.

Conocimientos

Problem-solving

Analytical skills

Communication skills

Educación

High School Diploma or GED

Herramientas

Microsoft Excel

Microsoft Outlook

Adobe Acrobat

Descripción del empleo

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Overview

We are seeking an experienced and detail-orientedClaims Adjusterto join our remote team on a1-year full-time contract. In this role, you will investigate, evaluate, and resolve claims in accordance with company guidelines, authority limits, and industry best practices. Your primary goal will be to ensure fair and timely settlements while maintaining high standards of accuracy, professionalism, and customer service.

While this is a fully remote position, candidates who reside in the Washington, DC metro area (including Maryland and Virginia) are strongly preferred to align with team collaboration and time zone needs.

What You’ll Do

• Investigate and adjust claims: Proactively handle standard and complex claims while adhering to authority limits, policies, and procedures.
• Maintain and update audit records: Accurately document claims activity, secure data, and ensure compliance with audit protocols.
• Settle claims: Approve or deny claims with careful consideration and sound judgment.
• Analyze and report trends: Provide audit summaries and contribute to process improvement through data insights.
• Grow your expertise: Attend training sessions to enhance your claims adjustment knowledge and skills.
• Duration:1-Year Full-Time Contract
• Schedule:Monday to Friday, standard business hours
• Work Environment:100% Remote – All equipment provided ( Washington DC, Maryland or Virginia applicants preferred to align with team collaboration and time zone needs.)

Qualifications

• Education:High School Diploma or GED (required)
• Experience:Minimum 5 years of hands-on claims adjustment experience
• Solid understanding of claims systems, policies, and procedures
• Strong problem-solving, analytical, and communication skills (verbal & written)
• Proficient in Microsoft Excel, Outlook, Adobe Acrobat, and related tools
• Ability to manage time effectively in a fast-paced, deadline-driven environment
• Comfortable interacting with challenging customers and providing high-quality service

Preferred Experience

• Familiarity with Inter-Plan Teleprocessing System (ITS) claims
• Proven ability to analyze and solve diverse and complex claim issues
• Strong attention to detail and commitment to accuracy

Candidates must disclose any debarment or exclusion that affects their ability to work directly or indirectly on Federal healthcare programs.

Why Join Us?

• 100% Remote: Work from the comfort of your home
• Stability: Full-time hours with a defined 1-year contract
• Supportive Team: Join a collaborative, experienced group of professionals
• Training Provided: Opportunities for skill development and growth

Apply Today!

If you’re a seasoned claims adjuster looking for a fully remote, contract-based role with a respected organization, we encourage you to apply now!

Job Types: Full-time, Contract

Pay: $22.00 - $24.00 per hour

Expected hours: 40 per week

Schedule:

• 8 hour shift

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  Hospitals and Health Care

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