Remote Claims Adjudicator II at UNITE HERE HEALTH

UNITE HERE HEALTH is hiring a Remote Claims Adjudicator II to support healthcare claims processing and benefits administration for members and providers nationwide. This fully remote position offers an opportunity to work within a healthcare claims environment while reviewing, verifying, and adjudicating medical, dental, vision, and disability claims.

This Remote Claims Adjudicator II role fits best as a low-phone healthcare position. While team members handle verbal and written inquiries from providers, participants, and internal departments, the majority of the work focuses on reviewing claims, verifying eligibility, analyzing documentation, and making benefit determinations.

Daily responsibilities include reviewing claims for completeness, verifying participant eligibility, interpreting benefit plans, evaluating diagnoses and procedure codes, and determining payment liability. The Claims Adjudicator also reviews medical documentation, requests additional information when needed, processes Medicare Secondary Payer files, handles Personal Injury Protection claims, and supports short-term disability claim processing.

The role requires a strong understanding of healthcare claims administration, benefit interpretation, medical terminology, ICD-10 coding, CPT coding, coordination of benefits, subrogation, and eligibility verification processes. Employees must meet productivity goals while maintaining accuracy and compliance with established procedures.

Candidates with experience in medical claims adjudication, healthcare claims processing, benefits administration, insurance claims, disability claims, or healthcare reimbursement may align well with this opportunity. Strong analytical abilities, attention to detail, documentation review skills, and healthcare knowledge are important for success in this role.

The pay range for this Remote Claims Adjudicator II position is $20.36 to $24.97 per hour. Following one week of paid onsite training in Oak Brook, Illinois, employees work fully remotely. Travel and lodging for training are paid by the employer.

Overall, this position is ideal for experienced healthcare claims professionals seeking a remote opportunity focused on claims adjudication, benefit analysis, eligibility review, and healthcare administration within a structured and quality-driven environment.