Health Insurance Claims Adjuster (Remote)

Lensa; Fairfax (VA); Remote; USD 55,000 - 65,000; Full time

Job summary

A leading company in the health insurance sector seeks a skilled Claims Adjuster for a fully remote position. This contract role involves thorough investigation of claims, ensuring accuracy and compliance with regulatory guidelines. Ideal for candidates with at least 5 years of experience in insurance claim handling, looking to enhance their analytical and problem-solving skills in a dynamic environment.

Qualifications

• Minimum 5 years of insurance claims handling experience.
• Comprehensive knowledge of claims systems, policies, and procedural guidelines.
• Strong analytical skills and the ability to interpret data.

Responsibilities

• Investigate and evaluate insurance claims while ensuring compliance with procedures.
• Maintain and update claims audit records.
• Compile and analyze claims data to support internal audit processes.

Skills

Analytical skills

Attention to detail

Problem-solving

Communication

Education

High School Diploma or GED

Job description

Health Insurance Claims Adjuster (Remote)

Health Insurance Claims Adjuster (Remote)

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Job Title: Claims Adjuster

Location: Remote

Type: Contract

Compensation: $26.75

Contractor Work Model: Remote

ALTA IT Services is seeking a skilled Claims Adjuster for a contract-to-hire opportunity with one of our health insurance clients. This role involves investigating and adjusting insurance claims to ensure they are processed accurately, efficiently, and in compliance with company procedures and regulatory guidelines. The ideal candidate will have strong analytical capabilities, attention to detail, and a solid understanding of insurance claims practices.

Pay: $26.75

100% Remote

Essential Functions

• Investigate and evaluate insurance claims, performing adjustments as necessary, while ensuring all actions are within assigned authority levels and in accordance with standard procedures and company policies.
• Maintain and update claims audit records by accurately entering, verifying, and securing claim-related data.
• Resolve both standard and complex claims through appropriate adjudication methods, including payment or denial.
• Compile and analyze claims data to support internal audit processes and identify trends or process improvement opportunities.
• Participate in training sessions and development activities to enhance job knowledge and remain current with industry standards.
  
  

Qualifications

Education:

• High School Diploma or GED required.
  
  

Experience

• Minimum 5 years of insurance claims handling experience.
• Comprehensive knowledge of claims systems, policies, and procedural guidelines.
  
  

Preferred Qualifications

Knowledge, Skills, and Abilities:

• Experience with inter-plan or multi-plan claim processing systems is a plus.
• Strong analytical skills and the ability to interpret data and identify anomalies.
• Excellent communication skills, both written and verbal.
• Effective problem-solving abilities to assess and resolve a variety of claim-related issues.
• High attention to detail and accuracy in processing and documentation.
  
  

Equal Opportunity Statement

ALTA IT Services is an Equal Opportunity Employer. We are committed to building a diverse and inclusive workplace and encourage all qualified individuals to apply.

#M2

Ref: #855-IT Baltimore

System One, and its subsidiaries including Joulé, ALTA IT Services, CM Access, TPGS, and MOUNTAIN, LTD., are leaders in delivering workforce solutions and integrated services across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible full-time employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  IT Services and IT Consulting

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