Remote Claims Adjudication Specialist

Highmark Health; Arizona; A distancia; USD 27.000 - 33.000; Jornada completa

Descripción de la vacante

Highmark Health is seeking a remote claims processor to review and adjudicate online and paper/electronic claims, ensuring accuracy and compliance with policies. The role involves processing claims data, verifying information, and determining eligibility and payment levels.

The position requires strong communication, analytical skills, and the ability to work across multiple systems. Remote work supports flexibility, with a pay range of $19.39–$24.19 per hour.

Formación

• High School Diploma or GED is required.
• 1 year of claim billing or processing experience preferred.
• Ability to navigate multiple systems and manage data accurately.

Responsabilidades

• Process claims data entry and verification for completeness and accuracy.
• Determine benefit eligibility and final payment amounts after reviewing edits.
• Communicate with customers and escalate issues as needed.
• Maintain records and complete required training and timekeeping.
• Perform other duties as assigned.

Conocimientos

Verbal communication

Written communication

Attention to detail

Multi-system navigation

Claims adjudication

Mathematics for claims

Educación

High School Diploma/GED

Herramientas

Claim processing systems

Descripción del empleo

Highmark Health is seeking a remote claims processor to review and adjudicate online and paper/electronic claims, ensuring accuracy and compliance with policies. The role involves processing claims data, verifying information, and determining eligibility and payment levels.

The position requires strong communication, analytical skills, and the ability to work across multiple systems. Remote work supports flexibility, with a pay range of $19.39–$24.19 per hour.