ATTENTION JOB SEEKERS AND MOLINA APPLICANTS: FRAUD ALERT
Be aware that third parties posing as Molina Healthcare may be soliciting money from job seekers and extending offers to candidates who have not interviewed. Molina does not engage in these type of practices. If you have received an offer and have not been engaging with Molina Healthcare in an interview process, reach out to erc@molinahealthcare.com to validate the legitimacy of your offer. Please note that Molina has reported this activity to the appropriate law enforcement agencies for further investigation. If you feel you’ve been victimized, please report it to local law enforcement.
Senior Examiner, Claims (Remote)
Molina Healthcare Long Beach, California; Albany, New York; Bowling Green, Kentucky; Bellevue, Nebraska; Lincoln, Nebraska; Kearney, Nebraska; Racine, Wisconsin; Florida; Layton, Utah; Tucson, Arizona; Owensboro, Kentucky; Miami, Florida; Covington, Kentucky; Davenport, Iowa; Syracuse, New York; Salt Lake City, Utah; Lexington-Fayette, Kentucky; Texas; Ohio; Macon, Georgia; Austin, Texas; Bellevue, Washington; Fort Worth, Texas; Columbus, Georgia; Savannah, Georgia; Nampa, Idaho; Ann Arbor, Michigan; Akron, Ohio; San Antonio, Texas; Buffalo, New York; Utah; Kentucky; Georgia; Des Moines, Iowa; Boise, Idaho; Roswell, New Mexico; Omaha, Nebraska; Dayton, Ohio; Albuquerque, New Mexico; Chandler, Arizona; Tampa, Florida; Grand Island, Nebraska; Provo, Utah; Columbus, Ohio; Detroit, Michigan; Yonkers, New York; Iowa City, Iowa; Orem, Utah; Cleveland, Ohio; Santa Fe, New Mexico; Meridian, Idaho; Mesa, Arizona; Kenosha, Wisconsin; Louisville, Kentucky; Wisconsin; Rio Rancho, New Mexico; Michigan; Houston, Texas; West Valley City, Utah; Cedar Rapids, Iowa; Phoenix, Arizona; Madison, Wisconsin; New Mexico; Warren, Michigan; Iowa; Washington; Idaho Falls, Idaho; Milwaukee, Wisconsin; Vancouver, Washington; Scottsdale, Arizona; Sioux City, Iowa; Augusta, Georgia; Rochester, New York; Atlanta, Georgia; St. Petersburg, Florida; Orlando, Florida; Grand Rapids, Michigan; Sterling Heights, Michigan; Dallas, Texas; Cincinnati, Ohio; Nebraska; New York; Idaho; Spokane, Washington; Everett, Washington; Caldwell, Idaho; Tacoma, Washington; Green Bay, Wisconsin; Jacksonville, Florida; Las Cruces, New Mexico Job ID 2033305JOB 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
- Meets and consistently maintains production standards for Claims Adjudication.
- Supports all department initiatives in improving overall efficiency.
- Identifies and recommends solutions for error issues as it relates to pre-payment of claims.
- Oversees the reduction of defects by identifying error issues as they relate to pre-payment of claims through adjudication and recommending solutions to resolve these issues.
- Monitors the medical treatment of claimants. Keeps meticulous notes and records for each claim.
- Manages a caseload of various types of complex claims. Procures all medical records and statements that support the claim.
- Meets department quality and production standards.
- Meet State and Federal regulatory Compliance Regulations on turnaround times and claims payment for multiple lines of business.
- Other duties as assigned.
JOB QUALIFICATIONS
Required Education
High School or GED
Required Experience
3-5 years claims processing required
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 years claims processing preferred
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: $21.16 - $34.88 / 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 08/25/2025Job Alerts
Sign up to receive automatic notices when jobs that match your interests are posted.
OPEN FORM