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Home › Companies › Fc217012 45a5 4270 A628 Cd13ee850dee 19000101 000001 › Claims Adjudicator II

Claims Adjudicator II

Fc217012 45a5 4270 A628 Cd13ee850dee 19000101 000001 · Oak Brook, IL, US, Oak Brook, IL · Remote · Active · $20–$25 / hour · ADP Workforce Now Recruiting

Job facts

FieldValue
CompanyFc217012 45a5 4270 A628 Cd13ee850dee 19000101 000001
TitleClaims Adjudicator II
Normalized title-
Department / team-
LocationOak Brook, IL, United States
Work modelRemote / Remote
Employment typeFull Time
Salary$20–$25 / hour
Statusactive
ATS providerADP Workforce Now Recruiting
Posted / first seen2026-05-01 / 2026-05-31
Changed / last seen2026-06-06 / 2026-06-06

Related slices

PageWhat it containsOpen
Company jobsActive postings from Fc217012 45a5 4270 A628 Cd13ee850dee 19000101 000001.Open
Company breakdownsRole, location, ATS, and work model facets for this company.Open
ATS provider jobsActive postings observed through ADP Workforce Now Recruiting.Open
Provider filtered searchThe same provider as a filtered job collection.Open
City jobsActive postings in Oak Brook.Open
Work model jobsActive Remote postings.Open
Lifecycle eventsOpen, update, close, and reopen events for this posting.Open
Original postingCanonical source or apply URL captured from the ATS.Open

Linked records

CompanyFc217012 45a5 4270 A628 Cd13ee850dee 19000101 000001
Sourcee6ed15b9-59db-4050-a935-548e2f9e1cb7
ATS providerADP Workforce Now Recruiting

Description

UNITE HERE HEALTH serves 200,000+ workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity! The Claims Adjudicator II position will receive, examine, verify and input submitted claim data, determine eligibility status, and review and adjudicate claims within established timeframes. This position utilizes multiple systems in order to perform the day-to-day functions of processing medical, disability, vision and dental claims, as well as, provider and member driven inquiries. ESSENTIAL JOB FUNCTIONS AND DUTIES Screens claims for completeness of necessary information Verifies participant/dependent eligibility Interprets the plan benefits from the Summary Plan Description (SPD)/Plan Documents Codes basic information and selects codes to determine payment liability amount Evaluates diagnoses, procedures, services, and other submitted data to determine the need for further investigation in relation to benefit requirements, accuracy of the claim filed, and the appropriateness or frequency of care rendered Determines the need for additional information or documentation from participants, employers, providers and other insurance carriers Handles the end to end process of Medicare Secondary Payer (MSP) files Processes Personal Injury Protection (PIP) claims Requests overpayment refunds, maintains corresponding files and performs follow-up actions Handles verbal and written inquiries received from internal and external customers Processes Short Term Disability claims Adjudicates claims according to established productivity and quality goals Achieve individual established goals in order to meet or exceed departmental metrics ESSENTIAL QUALIFICATIONS 3 ~ 5 years of direct experience minimum in a medical claim adjudication environment Working knowledge and experience in interpretation of benefit plans, including an understanding of limitations, exclusions, and schedule of benefits Experience with eligibility verification, medical coding, coordination of benefits, and subrogation and it’s related processes Experience with medical terminology, ICD10 and Current Procedural Technology (CPT) codes Fluency (speak and write) in Spanish, preferred Salary range for this position : Hourly $20.36 - $24.97. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. Work Schedule (may vary to meet business needs): Monday~Friday, 7.5 hours per day (37.5 hours per week) Fully Remote, after 1-week training onsite in Oak Brook, IL. (Travel and Lodging paid for by UHH) We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Pension, Short- & Long-term Disability, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP). #LIRemote

Full job record

Job ID3289c7c68e94e2298e60a3c39b5a7e318f680be0
Org ID96237476-ed03-486d-b1ca-f2ee6361b986
Source IDe6ed15b9-59db-4050-a935-548e2f9e1cb7
Board IDe6ed15b9-59db-4050-a935-548e2f9e1cb7
Provideradp_workforcenow
Provider Job Key567337
TitleClaims Adjudicator II
Normalized Title—
Statusactive
Activeyes
Location TextOak Brook, IL, US, Oak Brook, IL
Department—
Team—
Employment Typefull_time
Workplace Typeremote
Remote Policyremote
CountryUnited States
RegionIL
CityOak Brook
Salary Raw20.3589 To 24.9743 (USD) Hourly
Salary Min20.359
Salary Max24.974
Salary CurrencyUSD
Salary Periodhour
Source URLhttps://workforcenow.adp.com/mascsr/default/mdf/recruitment/recruitment.html?cid=fc217012-45a5-4270-a628-cd13ee850dee&ccId=19000101_000001&lang=en_US&type=JS&jobId=567337&jwId=9201069676063_1
Apply URLhttps://workforcenow.adp.com/mascsr/default/mdf/recruitment/recruitment.html?cid=fc217012-45a5-4270-a628-cd13ee850dee&ccId=19000101_000001&lang=en_US&type=JS&jobId=567337&jwId=9201069676063_1
First Seen At2026-05-31 18:59:10Z
Last Seen At2026-06-06 13:27:56Z
Last Checked At2026-06-06 13:27:56Z
Last Changed At2026-06-06 13:27:56Z
Inactive At—
Source Posted At2026-05-01 15:55:00Z
Source Updated At—
Raw Payload Uris3://job-postings-prod-raw-590183727216/raw/provider=adp_workforcenow/board=fc217012-45a5-4270-a628-cd13ee850dee|19000101_000001/date=2026-06-06/2026-06-06T13-27-56-105Z-59dda95973313c93d6cb5eebcaa3a7a960c553ec82c8ef8622c5e4741d9dfb9e.json
Event Fields
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Parsed Structured
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Extensions
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    "requisitionDescription": "<div><div><div><div><div><div><div><div><div><div><div><div><div data-pasted=\"true\"><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;line-height:normal;background:white;'><strong><span style=\"font-size: 16px; font-family: tahoma, sans-serif; color: black;\">UNITE </span></strong><span style=\"font-family: tahoma, sans-serif; font-size: 16px;\"><strong><span style=\"color: maroon;\">HERE</span></strong><strong><span style=\"color: rgb(0, 51, 102);\"> HEALTH</span></strong></span><span style=\"font-size: 16px; font-family: tahoma, sans-serif; color: black;\">&nbsp;</span><span style=\"color: rgb(0, 0, 0); font-family: tahoma, sans-serif; font-size: 16px;\">serves 200,000+ workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;line-height:normal;background:white;'><span style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\"><br></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;line-height:normal;background:white;'><span style=\"color: rgb(0, 0, 0); font-family: tahoma, sans-serif; font-size: 16px;\">The Claims Adjudicator II position will receive, examine, verify and input submitted claim data, determine eligibility status, and review and adjudicate claims within established timeframes. This position utilizes multiple systems in order to perform the day-to-day functions of processing medical, disability, vision and dental claims, as well as, provider and member driven inquiries.</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;text-align:justify;'><span style=\"color: rgb(0, 0, 0); font-family: tahoma, sans-serif; font-size: 16px;\">&nbsp;</span></p><p style='margin:0in;font-size:13px;font-family:\"Arial\",sans-serif;margin-left:.25in;text-align:center;text-indent:-.25in;'><span style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\"><strong><u>ESSENTIAL JOB FUNCTIONS AND DUTIES</u></strong>&nbsp;</span></p><ul style=\"list-style-type: disc;margin-left: -0.25in;\"><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Screens claims for completeness of necessary information</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Verifies participant/dependent eligibility</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Interprets the plan benefits from the Summary Plan Description (SPD)/Plan Documents</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Codes basic information and selects codes to determine payment liability amount</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Evaluates diagnoses, procedures, services, and other submitted data to determine the need for further investigation in relation to benefit requirements, accuracy of the claim filed, and the appropriateness or frequency of care rendered</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Determines the need for additional information or documentation from participants, employers, providers and other insurance carriers</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Handles the end to end process of Medicare Secondary Payer (MSP) files</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Processes Personal Injury Protection (PIP) claims</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Requests overpayment refunds, maintains corresponding files and performs follow-up actions</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Handles verbal and written inquiries received from internal and external customers</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Processes Short Term Disability claims</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Adjudicates claims according to established productivity and quality goals</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Achieve individual established goals in order to meet or exceed departmental metrics</li></ul><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:.25in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;text-align:center;text-indent:-.25in;'><span style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\"><strong><u>ESSENTIAL QUALIFICATIONS</u></strong></span></p><ul style=\"list-style-type: disc;margin-left: -0.25in;\"><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">3 ~ 5 years of direct experience minimum in a medical claim adjudication environment</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Working knowledge and experience in interpretation of benefit plans, including an understanding of limitations, exclusions, and schedule of benefits</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Experience with eligibility verification, medical coding, coordination of benefits, and subrogation and it&rsquo;s related processes</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Experience with medical terminology, ICD10 and Current Procedural Technology (CPT) codes</li><li style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">Fluency (speak and write) in Spanish, preferred</li></ul><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;line-height:normal;background:white;'><span style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\"><strong>&nbsp;</strong></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;line-height:normal;background:white;'><span style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\"><strong>Salary range for this position</strong></span><span style=\"color: rgb(0, 0, 0); font-family: tahoma, sans-serif; font-size: 16px;\">: Hourly $20.36 - $24.97. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location.</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;line-height:normal;background:white;'><span style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\"><strong style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; font-weight: 700; color: rgb(0, 0, 0); font-family: tahoma, sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;\" data-pasted=\"true\">Work Schedule (may vary to meet business needs): Monday~Friday, 7.5 hours per day (37.5 hours per week) Fully Remote, after 1-week training onsite in Oak Brook, IL. (Travel and Lodging paid for by UHH)</strong></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;line-height:normal;background:white;'><span style=\"color: rgb(0, 0, 0); font-family: tahoma, sans-serif; font-size: 16px;\"><em>We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Pension, Short- &amp; Long-term Disability, Life, AD&amp;D, Flexible Spending Accounts (healthcare &amp; dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP).</em></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;'><span style=\"font-family: tahoma, sans-serif; font-size: 16px; color: rgb(0, 0, 0);\">#LIRemote</span></p></div></div></div></div></div></div></div></div></div></div></div></div></div>\n",
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  "detail_errors": []
}
Get this page with API

Rendered from the bluedoor Job Postings API. Reproduce it:

GET https://api.bluedoor.sh/job-postings/v1/jobs/3289c7c68e94e2298e60a3c39b5a7e318f680be0?include=descriptionJSON
GET https://api.bluedoor.sh/job-postings/v1/orgs/96237476-ed03-486d-b1ca-f2ee6361b986JSON
GET https://api.bluedoor.sh/job-postings/v1/sources/e6ed15b9-59db-4050-a935-548e2f9e1cb7JSON
GET https://api.bluedoor.sh/job-postings/v1/jobs/3289c7c68e94e2298e60a3c39b5a7e318f680be0/eventsJSON

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