Home › Companies › Hckd Fa Us2 Oraclecloud Com CX 1 › Adjudicator, 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
| Field | Value |
|---|---|
| Company | Hckd Fa Us2 Oraclecloud Com CX 1 |
| Title | Adjudicator, Provider Claims - Remote Ohio On the phone-closing shift |
| Normalized title | - |
| Department / team | Operations |
| Location | OH, United States |
| Work model | Remote / Remote |
| Employment type | Full Time |
| Salary | - |
| Status | active |
| ATS provider | Oracle Recruiting Cloud / Fusion HCM |
| Posted / first seen | 2026-06-16 / 2026-06-17 |
| Changed / last seen | 2026-06-20 / 2026-06-22 |
Related slices
| Page | What it contains | Open |
|---|---|---|
| Company jobs | Active postings from Hckd Fa Us2 Oraclecloud Com CX 1. | Open |
| Company breakdowns | Role, location, ATS, and work model facets for this company. | Open |
| ATS provider jobs | Active postings observed through Oracle Recruiting Cloud / Fusion HCM. | Open |
| Provider filtered search | The same provider as a filtered job collection. | Open |
| Department jobs | Active postings in Operations. | Open |
| Work model jobs | Active Remote postings. | Open |
| Lifecycle events | Open, update, close, and reopen events for this posting. | Open |
| Original posting | Canonical source or apply URL captured from the ATS. | Open |
Linked records
| Company | Hckd Fa Us2 Oraclecloud Com CX 1 |
| Source | 8214b818-efda-4f30-9713-cac0e888e0f9 |
| ATS provider | Oracle 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 ID | 70c27c5ee8739dce393152c894299e2661d69730 |
| Org ID | 6fcfe228-ec8c-4e31-bf8d-2e5d2cb49f0a |
| Source ID | 8214b818-efda-4f30-9713-cac0e888e0f9 |
| Board ID | 8214b818-efda-4f30-9713-cac0e888e0f9 |
| Provider | oracle_hcm |
| Provider Job Key | 2037942 |
| Title | Adjudicator, Provider Claims - Remote Ohio On the phone-closing shift |
| Normalized Title | — |
| Status | active |
| Active | yes |
| Location Text | OH, United States; Remote Employees, Long Beach, CA, US |
| Department | Operations |
| Team | — |
| Employment Type | full_time |
| Workplace Type | remote |
| Remote Policy | remote |
| Country | United States |
| Region | OH |
| City | — |
| Salary Raw | 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 |
| Salary Min | — |
| Salary Max | — |
| Salary Currency | — |
| Salary Period | — |
| Source URL | https://hckd.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/2037942 |
| Apply URL | https://hckd.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/2037942 |
| First Seen At | 2026-06-17 11:25:12Z |
| Last Seen At | 2026-06-22 15:31:22Z |
| Last Checked At | 2026-06-22 15:31:22Z |
| Last Changed At | 2026-06-20 12:21:56Z |
| Inactive At | — |
| Source Posted At | 2026-06-16 16:56:05Z |
| Source Updated At | — |
| Raw Payload Uri | s3://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 |
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