Health Insurance Claims Processor

System One
Fairfax, VA
ALTA IT Services is staffing a contract to hire opportunity for a Healthcare Claims Processor to support a leading health insurance customer. The individual will review and adjudicate paper/electronic claims, also use automated system processes to send pending claims to ensure accurate completion according to medical policy, contracts, policies, and procedures allowing timely considerations to be generated using multiple systems. Pay rate $23/HR 100% Remote Must have experience doing 200+ claims daily ESSENTIAL FUNCTIONS + Performs claims adjudication for complex medical claims. + Performs regular auditing. + Schedules regular meetings with key provider groups to provide reporting and work through claim resolution issues. + Handles provider phone calls and emails regarding claims. + Generates weekly Claims Resolution reports for management in accordance with schedule set by supervisor. Requirements: + Required: High school education plus at least 2 years of experience in claims or related field. + Abilities/Skills: Must be detail-oriented, have good time management and organizational skills, analytical skills, written and oral communication skills, PC skills + Knowledge of Microsoft excel, Adobe PDF, ICD-10 and Medicaid. + Having a Laptop/PC + The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. System One, and its subsidiaries including Joulé, ALTA IT Services, and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions 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 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. #M2 #LI-AJ1 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.
Posted 2025-11-26

Recommended Jobs

CLOUD SYSTEMS ENGINEER (Top Secret Clearance REQUIRED)

NorthHill Technology
Fairfax, VA

KEY RESPONSIBILITIES:  Candidate is responsible for building and maintaining the cloud native system. Candidate must readily adapt to changing requirements; keep up-to-date on emerging technologies;…

View Details
Posted 2025-10-16

Corporate Senior Tax Manager

NorthPoint Search Group
Alexandria, VA

Senior Tax Accounting Manager – North Atlanta (On-site) A global manufacturing company with $4B+ in annual revenue is seeking a Senior Tax Accounting Manager to lead ASC 740 reporting and tax pr…

View Details
Posted 2025-11-29

Lead Platform Engineer x3

Mondo
Falls Church, VA

Apply now: Lead Platform Engineer, location is Hybrid. The start date is 2–3 weeks from offer for this 6 month contract position (with potential extension and conversion). Job Title: Lead Platf…

View Details
Posted 2025-08-23

Universal Banker - Part Time 20 Hrs - Hilltop

Truist
Virginia Beach, VA

**The position is described below. If you want to apply, click the Apply Now button at the top or bottom of this page. After you click Apply Now and complete your application, you'll be invited to cre…

View Details
Posted 2025-11-26

Quality Manager

The Building People
Quantico, VA

The Building People, LLC, has a position open for a Facilities Quality Manager. The Facilities Quality Manager will provide oversight and management of the facility operations and maintenance Qua…

View Details
Posted 2025-10-21

Windows IT Services Administrator

Connvertex Technologies Inc.
Herndon, VA

*** ONLY CANDIDATES LOCAL TO NORTHERN VIRGINIA AND WASHINGTON DC *** Client Name: Logix-Tech End Client Name: SAP Job Title: Windows IT Services Administrator Endpoint L…

View Details
Posted 2025-11-26

Part-time Landscape Assistant

Henry County / Henry County PSA
Henry County, VA

Welcome to Henry County, Virginia. One of the keys to our success is hiring good employees. Our employees are dedicated, service oriented individuals working together to serve our community. If you a…

View Details
Posted 2025-11-22

Sales Consultant Product Specialist

Lindsay Volkswagen of Dulles
Sterling, VA

Sales Professional – High-Volume New & Pre-Owned Volkswagen Retailer (Loudoun County, VA) Join a Winning Team. Build a Fulfilling Career. Are you a motivated, customer-focused sales profession…

View Details
Posted 2025-11-19

Cyber Intrusion Detection System Administrator - TS/SCI with Polygraph

GDIT
Reston, VA

Responsibilities for this Position Location: USA VA Reston Full Part/Time: Full time Job Req: RQ209219 Type of Requisition: Regular Clearance Level Must Currently Possess: Top …

View Details
Posted 2025-10-24

Security Officer - Commercial Property Patrols

Allied Universal
Herndon, VA

Allied Universal®, North America's leading security and facility services company, offers rewarding careers that provide you a sense of purpose. While working in a dynamic, welcoming, and collaborativ…

View Details
Posted 2025-11-26