Medical Claims Adjudicator

Job not on LinkedIn

🕒 September 25, 2025

🇺🇸 United States – Remote

💵 $38k - $45k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 41%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

CanAide

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 1998

🏥 Healthcare

☁️ SaaS

🤖 Artificial Intelligence

💰 Private equity on 2024-02

Healthcare • SaaS • Artificial Intelligence

CanAide is a healthcare-focused automation and technology company that delivers AI-powered robotic process automation, analytics, and support services to streamline revenue cycle management, patient eligibility and enrollment, and disability enrollment for hospitals, health systems, and government healthcare agencies. Its products include CanAide IA (Intelligent Automation) and CanAide IDP (Intelligent Denial Prevention), which use RPA, AI, and machine learning to reduce administrative burden, prevent claims denials, and improve financial performance; the company highlights 100+ successful automations and recognition for revenue cycle management.

📋 Description

• Analyzes and reviews claims received from a variety of sources for accuracy and compliance with provider contracts in place • Prepare claim authorizations in coordination with client referrals • Estimate future claim costs for an episode of care through clinical information, past experience and use of claim management software • Receive, process, and calculate claims payments in coordination with review of claim authorizations • As necessary, request and receive additional documentation from client representative • May receive phone/email inquiries from client representatives and respond in a concise and professional manner • Investigates discrepancies and resolves in accordance with pricing rules and program requirements • Process claims for payment recommendation in accordance with internal procedures • Review electronic claims and/or perform logging and data entry using a medical bill repricing software and web-based tools as needed • May conduct post adjudication audits of claims to ensure that they are adjudicated in accordance with program requirements • Assist in the compilation of statistics to support management reporting • Request and track the collection and storage of provider medical records as required by the program

🎯 Requirements

• High school diploma or GED • 5+ years of experience • Strong attention to detail • Exceptional knowledge of Medicare billing and reimbursement requirements • Must demonstrate strong understanding of federal HIPAA laws • Experienced in the use of medical claims payment and pricing systems • Exceptional analytical/problem solving skills • Excellent organizational skills • proficient in MS Office products including Word, Excel and Power Point

🏖️ Benefits

• medical • prescription drug • dental • vision • disability • retirement savings • competitive paid time off program