Health Insurance Claims Adjuster (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

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  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.

  
  
  
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  Maintain and update claims audit records by accurately entering, verifying, and securing claim-related data.

  
  
  
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  Resolve both standard and complex claims through appropriate adjudication methods, including payment or denial.

  
  
  
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  Compile and analyze claims data to support internal audit processes and identify trends or process improvement opportunities.

  
  
  
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  Participate in training sessions and development activities to enhance job knowledge and remain current with industry standards.

  
  
  
  
  
  Qualifications:
  
  

  Education:

  
  
  
  
  
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    High School Diploma or GED required.

    
    
    
    
    

    Experience:

    
    
    
    
    
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      Minimum 5 years of insurance claims handling experience.

      
      
      
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      Comprehensive knowledge of claims systems, policies, and procedural guidelines.

      
      
      
      
      
      Preferred Qualifications:
      
      

      Knowledge, Skills, and Abilities:

      
      
      
      
      
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        Experience with inter-plan or multi-plan claim processing systems is a plus.

        
        
        
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        Strong analytical skills and the ability to interpret data and identify anomalies.

        
        
        
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        Excellent communication skills, both written and verbal.

        
        
        
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        Effective problem-solving abilities to assess and resolve a variety of claim-related issues.

        
        
        
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        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