Remote Provider Claims Adjudicator (Ohio)

Molina Healthcare, Inc.; Columbus (OH); À distance; USD 23 000 - 44 000; Plein temps

Résumé du poste

Molina Healthcare is hiring a Provider Claims Adjudicator. This remote role requires living in Ohio and focuses on high-volume inbound calls from providers to resolve claim issues. You will review, adjust, and adjudicate provider claims with a focus on accuracy and timely service.

Responsibilities include researching adjustments, maintaining documentation, and collaborating with enrollment and claims teams to address issues. Strong communication is essential.

Qualifications

• At least 2 years in a clerical claims or customer service role within a managed care org.
• Experience researching and resolving provider claim issues.
• Strong data analysis, organization, and time-management skills.
• Excellent verbal and written communication; proficient with MS Office.

Responsabilités

• Adjudicate or readjudicate high volumes of provider claims promptly.
• Handle inbound calls from providers; document interactions and resolutions.
• Research tracers, adjustments, and resubmissions of claims.
• Collaborate with internal teams to resolve claims issues and ensuring quality.
• Support provider claims adjudication activities and respond to inquiries.

Connaissances

Managed Care / MCO claims

Call center claims experience

Billing & Appeals and Grievances

Provider customer service

Claims adjudication / research

Documentation and communication

Data analysis

Outils

Microsoft Office

Description du poste

Molina Healthcare is hiring a Provider Claims Adjudicator. This remote role requires living in Ohio and focuses on high-volume inbound calls from providers to resolve claim issues. You will review, adjust, and adjudicate provider claims with a focus on accuracy and timely service.

Responsibilities include researching adjustments, maintaining documentation, and collaborating with enrollment and claims teams to address issues. Strong communication is essential.