Claims Specialist: Precision Adjustments & Fast Resolutions

Independence Blue Cross, LLC; Philadelphia (Philadelphia County); On-site; USD 42,000 - 62,000; Full time

Job summary

Independence Blue Cross, LLC is seeking a detail-oriented claims processor to handle Local and Commercial PA, AHNJ, and Government market issues with timely, accurate processing.

The role requires 1–3 years in production, strong math and communication skills, and proficient MS Office use (Excel/Word). You will research inquiries, adjust payments as needed, and meet quality targets in a collaborative environment.

Qualifications

• High School diploma or equivalent is required.
• 1–3 years of proven work experience in a production environment.
• Demonstrated math and comprehension skills are required.
• Good interpersonal skills for handling internal and external customers.
• Well-developed listening, verbal and written communication skills.
• Proficiency with Microsoft Office, specifically Excel and Word.
• Ability to research and investigate information using multiple sources and documented guidelines.
• Strong organizational skills and problem solving ability.
• Detail-oriented.

Responsibilities

• Handle claim issues timely and accurately for Local and Commercial PA, AHNJ, and Government market.
• Research inquiries from internal and external sources; adjust payable claim payments following guidelines.
• Meet departmental quality and production requirements.
• Respond professionally to inquiries while maintaining standards.
• Research paid claims to recover overpaid/underpaid dollars and process adjustments.
• Provide responses to general questions with updates and resolution dates for complex issues.
• Complete special projects and participate in work groups as assigned.
• Perform other duties as necessary.

Skills

Math

Interpersonal skills

Communication

Organizational skills

Attention to detail

Education

High School diploma or equivalent

Tools

Microsoft Office

Job description

Independence Blue Cross, LLC is seeking a detail-oriented claims processor to handle Local and Commercial PA, AHNJ, and Government market issues with timely, accurate processing.

The role requires 1–3 years in production, strong math and communication skills, and proficient MS Office use (Excel/Word). You will research inquiries, adjust payments as needed, and meet quality targets in a collaborative environment.