Remote Claims Adjudication Specialist

Highmark Health; Beryl (WV); Remote; USD 27,000 - 33,000; Full time

Job summary

Highmark Inc. is seeking a detail-oriented claims processing specialist to screen, review, and adjudicate online and paper claims. You will determine eligibility, correct errors, and ensure timely processing according to policy.

Responsibilities include entering and verifying data, resolving edits, reviewing history records, and communicating with customers. Remote work is available, with emphasis on accuracy and adherence to HIPAA policies.

Qualifications

• High school diploma or GED required.
• 1 year claim billing or processing experience preferred.
• Strong verbal and written communication.
• Ability to use multiple systems.
• Knowledge of claims processing systems.

Responsibilities

• Receives and processes claims; enters/verifies data.
• Determines claim completeness and correctness.
• Resolves claim edits and determines benefit eligibility.
• Communicates with customers and supervisors as needed.
• Maintains records and completes required training.

Education

High School Diploma/GED

Job description

Highmark Inc. is seeking a detail-oriented claims processing specialist to screen, review, and adjudicate online and paper claims. You will determine eligibility, correct errors, and ensure timely processing according to policy.

Responsibilities include entering and verifying data, resolving edits, reviewing history records, and communicating with customers. Remote work is available, with emphasis on accuracy and adherence to HIPAA policies.