Healthcare Claims Specialist - High-Volume Support

Highmark; United States; On-site; USD 26,000 - 36,000; Full time

Job summary

Highmark Inc. in New York state is seeking a Customer Service Specialist to provide quality service in a high-volume contact center.

The role includes responding to inquiries from subscribers, members, providers, and other stakeholders, and processing and adjusting claims. The candidate will handle calls and correspondence, communicate benefits and plan details, and coordinate with internal teams to resolve MSP and claim issues.

Qualifications

• HS/GED required.
• One year customer service, contact center, or healthcare related experience is required.
• Two years customer service in a high volume call center is preferred.

Responsibilities

• Responds to and resolves inquiries from subscribers, members, providers, facilities, groups, other plans and other departments.
• Pursues, researches, tracks and follows up on information regarding claim benefits, eligibility and all other aspects of business.
• Processes and adjusts claims for all lines of business.
• Researches and compiles information pertaining to all potential subrogation cases and forwards to vendor.
• Delivers customer service in a professional, polite and efficient manner.
• Maintains confidentiality and adheres to HIPAA regulations.

Skills

Customer service

Call center

Healthcare knowledge

Education

HS/GED

Job description

Highmark Inc. in New York state is seeking a Customer Service Specialist to provide quality service in a high-volume contact center.

The role includes responding to inquiries from subscribers, members, providers, and other stakeholders, and processing and adjusting claims. The candidate will handle calls and correspondence, communicate benefits and plan details, and coordinate with internal teams to resolve MSP and claim issues.