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HomeCompaniesHckd Fa Us2 Oraclecloud Com CX 1Adjudicator, Provider Claims - Remote Ohio On the phone-closing shift

Adjudicator, Provider Claims - Remote Ohio On the phone-closing shift

Hckd Fa Us2 Oraclecloud Com CX 1 · OH, United States; Remote Employees, Long Beach, CA, US · Remote · Active · Oracle Recruiting Cloud / Fusion HCM

Job facts

FieldValue
CompanyHckd Fa Us2 Oraclecloud Com CX 1
TitleAdjudicator, Provider Claims - Remote Ohio On the phone-closing shift
Normalized title-
Department / teamOperations
LocationOH, United States
Work modelRemote / Remote
Employment typeFull Time
Salary-
Statusactive
ATS providerOracle Recruiting Cloud / Fusion HCM
Posted / first seen2026-06-16 / 2026-06-17
Changed / last seen2026-06-20 / 2026-06-22

Related slices

PageWhat it containsOpen
Company jobsActive postings from Hckd Fa Us2 Oraclecloud Com CX 1.Open
Company breakdownsRole, location, ATS, and work model facets for this company.Open
ATS provider jobsActive postings observed through Oracle Recruiting Cloud / Fusion HCM.Open
Provider filtered searchThe same provider as a filtered job collection.Open
Department jobsActive postings in Operations.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

CompanyHckd Fa Us2 Oraclecloud Com CX 1
Source8214b818-efda-4f30-9713-cac0e888e0f9
ATS providerOracle Recruiting Cloud / Fusion HCM

Description

Description JOB DESCRIPTION Job Summary Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. Hours - M-F 12pm -8:30pm EST Essential Job Duties Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. Strong claims adjusting experience as well and customer services, problem solving, critical thinking skills and research and resolution skills. • Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. • Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. • Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. • Assists in reviews of state and federal complaints related to claims. • Collaborates with other internal departments to determine appropriate resolution of claims issues. • Researches claims tracers, adjustments, and resubmissions of claims. • Adjudicates or readjudicates high volumes of claims in a timely manner. • Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. • Meets claims department quality and production standards. • Supports claims department initiatives to improve overall claims function efficiency. • Completes basic claims projects as assigned. Required Qualifications • At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. • Research and data analysis skills. • Organizational skills and attention to detail. •Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. • Customer service experience. • Effective verbal and written communication skills. • Microsoft Office suite and applicable software programs proficiency. Knowledgeable In Systems Utilized Salesforce QNXT Pega Claim Shark Cotiviti To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Full job record

Job ID70c27c5ee8739dce393152c894299e2661d69730
Org ID6fcfe228-ec8c-4e31-bf8d-2e5d2cb49f0a
Source ID8214b818-efda-4f30-9713-cac0e888e0f9
Board ID8214b818-efda-4f30-9713-cac0e888e0f9
Provideroracle_hcm
Provider Job Key2037942
TitleAdjudicator, Provider Claims - Remote Ohio On the phone-closing shift
Normalized Title
Statusactive
Activeyes
Location TextOH, United States; Remote Employees, Long Beach, CA, US
DepartmentOperations
Team
Employment Typefull_time
Workplace Typeremote
Remote Policyremote
CountryUnited States
RegionOH
City
Salary RawDescription JOB DESCRIPTION Job Summary Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. Hours - M-F 12pm -8:30pm EST Essential Job Duties Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. Strong claims adjusting experience as well and customer services, problem solving, critical thinking skills and research and resolution skills. • Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. • Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. • Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. • Assists in reviews of state and federal complaints related to claims. • Collaborates with other internal departments to determine appropriate resolution of claims issues. • Researches claims tracers, adjustments, and resubmissions of claims. • Adjudicates or readjudicates high volumes of claims in a timely manner. • Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. • Meets claims department quality and production standards. • Supports claims department initiatives to improve overall claims function efficiency. • Completes basic claims projects as assigned. Required Qualifications • At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. • Research and data analysis skills. • Organizational skills and attention to detail. •Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. • Customer service experience. • Effective verbal and written communication skills. • Microsoft Office suite and applicable software programs proficiency. Knowledgeable In Systems Utilized Salesforce QNXT Pega Claim Shark Cotiviti To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Salary Min
Salary Max
Salary Currency
Salary Period
Source URLhttps://hckd.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/2037942
Apply URLhttps://hckd.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/2037942
First Seen At2026-06-17 11:25:12Z
Last Seen At2026-06-22 15:31:22Z
Last Checked At2026-06-22 15:31:22Z
Last Changed At2026-06-20 12:21:56Z
Inactive At
Source Posted At2026-06-16 16:56:05Z
Source Updated At
Raw Payload Uris3://job-postings-prod-raw-590183727216/raw/provider=oracle_hcm/board=hckd.fa.us2.oraclecloud.com|CX_1/date=2026-06-22/2026-06-22T15-30-42-407Z-003d74e3b16b9a4b88f1697fbbcd06bf6bab7e4f4e37a6516765c89e1523a04e.json
Event Fields
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  "last_changed_at": "2026-06-20T12:21:56.493Z",
  "active_status": "active"
}
Parsed Structured
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  },
  "remote_policy": "remote",
  "salary_period": null,
  "workplace_type": "remote",
  "salary_currency": null
}
Extensions
{}
Native Structured
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