Claims Adjuster

nTech Workforce; United States; Remote; USD 54,000 - 65,000; Full time

Job summary

nTech Workforce is seeking a Senior Talent Acquisition Specialist for a remote role focused on medical claims processing. In this key position, you will ensure claim accuracy and financial integrity while working with a leading healthcare provider. Ideal candidates will possess extensive experience in claims management and proficiency in Microsoft applications.

Qualifications

• Minimum five years of experience in medical claims processing.
• Experience with claims adjudication and payment error correction.
• High level of proficiency in basic Excel and Outlook.

Responsibilities

• Analyze and adjust previously processed medical claims.
• Process new medical claims as needed.
• Ensure adjustments comply with benefit plans.

Skills

Claims adjudication

Time management

Excel

Communication

Education

High School Diploma or GED

Tools

Microsoft Excel

Outlook

Job description

1 week ago Be among the first 25 applicants

Direct message the job poster from nTech Workforce

Senior Talent Acquisition Specialist at nTech Workforce

Pay Rate: $26/hr on W2

Terms of Employment:

• This position is 100% remote. Candidates must reside in Maryland, Washington, DC, Virginia, West Virginia, Pennsylvania, Delaware, New Jersey, New York, North Carolina, Florida, or Texas.

Overview:

Join a leading healthcare provider as a remote Claims Adjuster! In this crucial role, you'll ensure the accuracy of previously paid medical claims. You will investigate, correct, and re-process claims due to benefit changes, errors, or overpayments, playing a key part in maintaining financial integrity and member satisfaction. This is a fantastic remote opportunity with the potential for permanent hire. You will…

• Analyze and adjust previously processed medical claims (approx. 75% of duties).

• Process new medical claims as needed (approx. 25% of duties).

• Identify overpayments, issue overpayment letters, and track/process refunds.

• Ensure adjustments comply with benefit plans and processing guidelines.

• Utilize Excel for reporting and Outlook for communication.

• Meet established production and accuracy standards.

Required Qualifications:

• A minimum of five (5) years of experience in medical claims processing, adjudication, and adjusting.

• Demonstrated experience with claims adjudication, coordination of benefits (COB), and correcting payment errors.

• Proficiency in basic Microsoft Excel (sorting, filtering) and Outlook.

• Excellent time management skills and ability to work independently in a remote setting.

• High School Diploma or GED.

Preferred Qualifications:

• Experience with Inter Plan Tele processing System (ITS), TPA, or CFA (Strongly Preferred).

• Experience with the LuminX claims system.

• Familiarity with the Blue Square system.

• Knowledge of medical terminology.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Contract

Job function

• Job function

  Administrative

• Industries

  Hospitals and Health Care and Public Health

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