Examiner, Claims-Florida
Molina Healthcare Florida, Massachusetts Job ID 2032657JOB DESCRIPTION
Job Summary
Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.
KNOWLEDGE/SKILLS/ABILITIES
- Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims.
- Manages a caseload of claims. Procures all medical records and statements that support the claim.
- Makes recommendations for further investigation or resolution.
- Reduces defects via pro-active identification of error issues as it relates to pre-payment of claims through adjudication and trends and recommending solutions to resolve these issues.
- Supports all department initiatives in improving overall efficiency.
- Meets department quality and production standards.
- Other duties as assigned.
JOB QUALIFICATIONS
Required Education
HS Diploma or GED
Required Experience
1-3 years
Preferred Education
Associate degree or equivalent combination of education and experience
Preferred Experience
3-5 years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $15.58 - $30.39 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 07/15/2025ABOUT OUR LOCATION
View Map- Associate Actuarial Analyst - REMOTE Waterbury Connecticut, Stamford Connecticut, New Haven Connecticut, Bridgeport Connecticut, Hartford Connecticut, Arizona, Grand Island Nebraska, Phoenix Arizona, Orem Utah, Provo Utah, Salt Lake City Utah, Bellevue Washington, Sterling Heights Michigan, Mesa Arizona, Savannah Georgia, Michigan, Akron Ohio, Layton Utah, Rio Rancho New Mexico, Kearney Nebraska, Grand Rapids Michigan, Spokane Washington, Albany New York, Green Bay Wisconsin, Santa Fe New Mexico, Dayton Ohio, Ohio, Orlando Florida, Louisville Kentucky, Des Moines Iowa, Racine Wisconsin, Vancouver Washington, Sioux City Iowa, Covington Kentucky, Bellevue Nebraska, Meridian Idaho, Albuquerque New Mexico, Syracuse New York, Georgia, Yonkers New York, Fort Worth Texas, Columbus Georgia, Houston Texas, Dallas Texas, Warren Michigan, Chandler Arizona, Tampa Florida, Tacoma Washington, Kentucky, New York, Iowa, Cedar Rapids Iowa, Owensboro Kentucky, West Valley City Utah, Kenosha Wisconsin, Wisconsin, Jacksonville Florida, San Antonio Texas, Texas, Columbus Ohio, Las Cruces New Mexico, Buffalo New York, Everett Washington, Lincoln Nebraska, Austin Texas, Augusta Georgia, St. Petersburg Florida, New Mexico, Nebraska, Iowa City Iowa, Rochester New York, Cincinnati Ohio, Madison Wisconsin, Davenport Iowa, Scottsdale Arizona, Nampa Idaho, Lexington-Fayette Kentucky, Caldwell Idaho, Cleveland Ohio, Washington, Utah, Idaho, Miami Florida, Macon Georgia, Tucson Arizona, Idaho Falls Idaho, Roswell New Mexico, Boise Idaho, Omaha Nebraska, Bowling Green Kentucky, Atlanta Georgia, Detroit Michigan, Florida, Ann Arbor Michigan, Milwaukee Wisconsin 06/13/2025
- Corporate Development Manager Albany New York, Everett Washington, Seattle Washington, New York New York, Rio Rancho New Mexico, Columbus Ohio, Tucson Arizona, Houston Texas, Salt Lake City Utah, Des Moines Iowa, Lexington-Fayette Kentucky, Bowling Green Kentucky, Covington Kentucky, Ann Arbor Michigan, Grand Island Nebraska, Spokane Washington, Georgia, Kentucky, Las Cruces New Mexico, Scottsdale Arizona, Miami Florida, Columbus Georgia, Meridian Idaho, Ohio, Texas, Albuquerque New Mexico, Yonkers New York, Syracuse New York, Chandler Arizona, Fort Worth Texas, Iowa City Iowa, Orem Utah, Tacoma Washington, Milwaukee Wisconsin, Nebraska, New York, Washington, Michigan, Santa Fe New Mexico, Rochester New York, Orlando Florida, Warren Michigan, Bellevue Nebraska, Kearney Nebraska, Layton Utah, Roswell New Mexico, Akron Ohio, Mesa Arizona, Tampa Florida, Macon Georgia, Dayton Ohio, Caldwell Idaho, Sioux City Iowa, Omaha Nebraska, New Mexico, Florida, Buffalo New York, Phoenix Arizona, Dallas Texas, West Valley City Utah, Provo Utah, Louisville Kentucky, Owensboro Kentucky, Sterling Heights Michigan, Lincoln Nebraska, Vancouver Washington, Bellevue Washington, Kenosha Wisconsin, Utah, Wisconsin, Idaho, Jacksonville Florida, Atlanta Georgia, Nampa Idaho, Austin Texas, Cedar Rapids Iowa, Cleveland Ohio, Cincinnati Ohio, St. Petersburg Florida, Augusta Georgia, Savannah Georgia, Boise Idaho, Idaho Falls Idaho, San Antonio Texas, Davenport Iowa, Detroit Michigan, Grand Rapids Michigan, Madison Wisconsin, Green Bay Wisconsin, Racine Wisconsin, Iowa 05/27/2025
- Senior Configuration Analyst - QNXT Nampa Idaho, Iowa City Iowa, Dayton Ohio, Miami Florida, Layton Utah, Phoenix Arizona, Ohio, Albany New York, Des Moines Iowa, Columbus Georgia, Kearney Nebraska, Atlanta Georgia, Macon Georgia, Syracuse New York, Michigan, Washington, Mesa Arizona, Louisville Kentucky, Salt Lake City Utah, Bellevue Washington, Savannah Georgia, Lincoln Nebraska, Green Bay Wisconsin, Roswell New Mexico, Orlando Florida, Detroit Michigan, Yonkers New York, Vancouver Washington, Orem Utah, Albuquerque New Mexico, Idaho, Iowa, Bellevue Nebraska, Owensboro Kentucky, West Valley City Utah, Omaha Nebraska, Augusta Georgia, Akron Ohio, Jacksonville Florida, Provo Utah, Milwaukee Wisconsin, Las Cruces New Mexico, Grand Rapids Michigan, Rio Rancho New Mexico, Columbus Ohio, Buffalo New York, Warren Michigan, Covington Kentucky, Davenport Iowa, Ann Arbor Michigan, Rochester New York, Bowling Green Kentucky, San Antonio Texas, Utah, Texas, New Mexico, Kentucky, Madison Wisconsin, Kenosha Wisconsin, Dallas Texas, Meridian Idaho, St. Petersburg Florida, Tucson Arizona, Florida, Fort Worth Texas, Caldwell Idaho, Tacoma Washington, Racine Wisconsin, Cedar Rapids Iowa, Georgia, Nebraska, Grand Island Nebraska, Idaho Falls Idaho, Cleveland Ohio, Everett Washington, Tampa Florida, Cincinnati Ohio, Lexington-Fayette Kentucky, Boise Idaho, Sioux City Iowa, Santa Fe New Mexico, Houston Texas, Scottsdale Arizona, New York, Wisconsin, Spokane Washington, Chandler Arizona, Sterling Heights Michigan, Austin Texas 05/16/2025
- Sr QNXT Analyst Albany New York, Everett Washington, Macon Georgia, Meridian Idaho, Caldwell Idaho, Nampa Idaho, Kentucky, Vancouver Washington, Boise Idaho, Michigan, Detroit Michigan, Lincoln Nebraska, Omaha Nebraska, New Mexico, Rio Rancho New Mexico, Cleveland Ohio, Columbus Ohio, Austin Texas, Orem Utah, Seattle Washington, Davenport Iowa, Bowling Green Kentucky, Las Cruces New Mexico, Buffalo New York, Racine Wisconsin, Georgia, Iowa, Louisville Kentucky, Owensboro Kentucky, Nebraska, Akron Ohio, San Antonio Texas, Fort Worth Texas, Dallas Texas, Houston Texas, Provo Utah, Utah, Bellevue Washington, Tampa Florida, Idaho Falls Idaho, Grand Rapids Michigan, Sterling Heights Michigan, Rochester New York, New York, Mesa Arizona, Chandler Arizona, Augusta Georgia, Savannah Georgia, Iowa City Iowa, Des Moines Iowa, Idaho, Lexington-Fayette Kentucky, Covington Kentucky, Warren Michigan, Kearney Nebraska, Albuquerque New Mexico, Santa Fe New Mexico, Roswell New Mexico, Ohio, Layton Utah, Green Bay Wisconsin, Wisconsin, Phoenix Arizona, Columbus Georgia, Sioux City Iowa, Cedar Rapids Iowa, Ann Arbor Michigan, Syracuse New York, Yonkers New York, Cincinnati Ohio, Texas, West Valley City Utah, Washington, Madison Wisconsin, Florida, Atlanta Georgia, Grand Island Nebraska, Bellevue Nebraska, New York New York, Dayton Ohio, Salt Lake City Utah, Tacoma Washington, Spokane Washington, Milwaukee Wisconsin, Kenosha Wisconsin, Tucson Arizona, Scottsdale Arizona, Miami Florida, St. Petersburg Florida, Orlando Florida, Jacksonville Florida 06/20/2025
No recently viewed jobs.
View All JobsNo saved jobs.
View All Jobs