Adjuster, Claims (Remote)

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Molina Healthcare. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. JOB DESCRIPTION Job Summary Provides support for claims adjustment activities including administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Also monitors and controls backlog and workflow of claims, and ensures that claims are settled in a timely fashion and in accordance with cost-control standards. Essential Job Duties

• Researches claims tracers, adjustments and resubmissions.
• Assists with defect reduction by identifying and communicating claims error issues and potential solutions to leadership.
• Adjudicates or readjudicates claims in a timely manner.
• Meets claims department quality and production standards.
• Supports claims department initiatives to improve overall claims function efficiency.
• Completes basic claims projects as assigned.

Required Qualifications

• At least 1 year of experience in a clerical role in a claims, and/or customer service setting - preferably in managed care, or equivalent combination of relevant education and experience.
• Data entry and research skills.
• Organizational skills and attention to detail.
• Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Customer service experience.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

• Health care claims/billing experience.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $17.85 - $26.42 / HOURLY

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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