Jobs Search

Remote Claims Adjudicator

Addison Group • Contract • Remote (Illinois, United States) • 1w ago

Job Title: Remote Claims Adjudicator

Location: Remote (open to all U.S. locations except California and New York; preference for Illinois)

Industry: Healthcare – Claims Processing

Pay: $25 – $27 / hour (depending on experience)

Benefits: Dental , Vision , Medical , 401k

About Our Client:

Our client is a leading value-based care and managed service organization that partners with independent providers to drive transformative change in healthcare. This role is fully remote and part of a growing national team.

Job Description:

The Claims Adjudicator will play a key role in supporting critical aspects of claims examination, focusing on authorization matching, duplicate claim identification, and adjudication of BCBS HMO claims. This production-based position is designed to help reduce a significant claims backlog while ensuring accuracy and compliance with guidelines.

Key Responsibilities:

Approve or deny claims for payment by verifying proper authorizations and resolving system hold codes
Review claims against established criteria (dates, codes, etc.) to authorize payment
Identify duplicate claims and support denial processes during adjudication
Coordinate benefits and payments between multiple insurance companies (COB savings)
Investigate and resolve claims issues from Customer Service inquiries
Analyze recurring provider or member issues, recommend solutions to management
Provide feedback to update standard operating procedures
Maintain HIPAA compliance regarding patient privacy
Contribute to team goals and productivity standards

Qualifications:

2+ years of medical claims processing experience (BCBS HMO preferred)
Experience working with UB04 and CMS-1500 claim forms
Strong understanding of claims adjudication steps and denial management
Production-focused and comfortable working independently
Proficient in Microsoft Office (Outlook, Teams, Word, Excel)
Prior experience with EZCap claims software preferred
Availability to work an 8-hour shift between 7:00 AM – 6:00 PM CST

Additional Details:

Type of Assignment: Contract through end of year
Productivity Target: 50 – 60 claims / day
Environment: Remote, production-focused
Compliance: Background check and drug screen required

Perks:

Fully remote opportunity with national impact
Work for a leading value-based healthcare organization
Opportunity to gain exposure to complex claims processing and denial management
Supportive and collaborative leadership team

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

IND 004-008

Related Jobs

Marketing Communication Specialist / Contract / Remote

Motion Recruitment • Remote (TBD, Illinois, United States) • $43 - $50 / hour • 4d ago

Fully Remote

Our global SaaS client seeks a contract Marketing Communication Specialist. This is a fully remote role. This role will collaborate globally with members of the client’s global communications and brand team, as well as i...

4d ago

Apply

Attending Veterinarian

Abbott • Contract • Remote (North Chicago, IL, US) • $140 - $146 / hour • 1w ago

Fully Remote

Title : Attending Veterinarian Location : Abbott Park, Illinois Duration : 12 Month Assignment Part-Time 100% Onsite The average weekly hours will be approximately 10. However, there will be fluctuations based on animal...

1w ago

Apply

Licensed Reimbursement Therapy Representative

Addison Group • Contract • Remote (Illinois, Illinois, United States) • 2w ago

Fully Remote

Job Title: Reimbursement Specialist - Therapy Location: Remote – MUST RESIDE IN ILLINOIS & HOLD AN IL PHARMACY TECH CERTIFICATION Industry: Healthcare / Specialty Pharmacy Pay: $21 – $24 per/hour (based on experience...

2w ago

Apply

Project Management Coordinator

Addison Group • Contract • Remote (Chicago, Illinois, United States) • 1m ago

Fully Remote

Job Title: Project Management Coordinator Location: Chicago, IL Industry: Hospitality/Corporate Services Pay: $38–$40/hour About Our Client: Addison Group is hiring for our client, a global leader in the hospitality indu...

1m ago

Apply

Database Coordinator

CAI • Permanent • Illinois, United States • 17h ago

Data

Job ID Number R5627 Employment Type Full time Worksite Flexibility Onsite Job Summary We are looking for a motivated Database Coordinator ready to take us to the next level! If you have strong database experience and a d...

17h ago

Apply

Mechanic I - Nights

Lowe's • Permanent • Illinois, United States • 19h ago

Your Impact at Lowe's As a maintenance Mechanic I, you play an important role in keeping our distribution center running smoothly. By quickly and independently fixing equipment issues in different areas, you'll help main...

19h ago

Apply

3rd Shift Material Stager - $19.80/hr

Stevens Industries • Permanent • Illinois, United States • $19.80 / * • 1d ago

Description At Stevens Industries, we pride ourselves on delivering high-quality products through innovative manufacturing processes. We are seeking dedicated and detail-oriented individuals to join our team as Material...

1d ago

Apply

Senior Product Analytics Manager

American Express Global Business Travel • Permanent • Illinois, United States • 1d ago

Amex GBT is a place where colleagues find inspiration in travel as a force for good and - through their work - can make an impact on our industry. We're here to help our colleagues achieve success and offer an inclusive...

1d ago

Apply

Scrum Master / Contract To Hire / Hybrid in South Suburbs of Chicago

Motion Recruitment • Chicago, Illinois, United States • $60 - $75 / hour • 2d ago

Software Company looking for a Senior Scrum Master to help implement an AGILE environment as they go through a digital transformation. You will be in charge of two scrum teams while planning various projects, managing th...

2d ago

Apply

QA Tester / Contract To Hire / Hybrid / South Suburbs of Chicago

Motion Recruitment • Chicago, Illinois, United States • $45 - $55 / hour • 2d ago

Retail company looking for a QA Tester. You will be testing software, Hybrid opportunity located in the south suburbs of Chicago. They are looking for someone with manual testing experience and someone interested in get...

2d ago

Apply