Adjudicator, Provider Claims - Remote (Inbound Provider Calls)
Molina Healthcare · United States · US
Other
Remote
Not yet analysed
Demand66
Career growth45
Healthcare fit58
Remote potential95
5-year outlook
Stable payer operations role with limited salary upside unless moving into claims leadership, payment integrity, coding/audit, or appeals management. Remote availability may persist, but routine adjudication could face automation pressure over time.
Clinical license
Not required
Applicant reach
moderate
Seniority
junior
Employment type
full-time
Date found
2026-11-08
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth considering for clinicians who want a remote entry point into payer claims operations and already have billing, insurance, or customer-service exposure. It is less compelling for clinicians seeking higher-ceiling health tech, informatics, strategy, or clinical-adjacent roles.
Who should apply
Nurses, IMGs, healthcare graduates, and allied health professionals with insurance, billing, prior authorization, or customer-service experience who want to move into managed care operations. It is less suitable for clinicians seeking clinical research, health tech, or strategic non-clinical roles unless used as a short-term payer entry point.
CV angle
Highlight real experience with insurance denials, prior authorization, billing or coding exposure, EMR documentation, patient/provider communication, customer service, quality metrics, and high-volume administrative accuracy. Frame clinical work as evidence of provider-facing communication and understanding reimbursement workflows, but do not claim claims adjudication experience unless it actually exists.
Skills to highlight
- Provider communication
- Claims research and investigation
- Insurance reimbursement and managed care exposure
- Customer service and issue resolution
- Data analysis and attention to detail
- Microsoft Office and documentation
- Time management in high-volume settings
- Quality and production standards
Role summary
A remote payer operations role handling inbound provider calls and resolving claims issues, including researching, adjudicating, and readjudicating claims. It requires claims or customer-service experience, strong documentation, and collaboration with enrollment, provider data, benefits, and claims processing teams.
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