Remote Claims Adjudication Specialist

Highmark Health; Bismarck (ND); A distancia; USD 27.000 - 33.000; Jornada completa

Descripción de la vacante

Highmark Inc. is seeking a remote claims processor to screen, review, and adjudicate online and paper/electronic claims.

You will determine if claims should be returned, denied, or paid, following established policies and procedures. The role involves correcting errors, coordinating benefits, and communicating with customers while maintaining timely and accurate work, supported by standard HIPAA and privacy guidelines.

Formación

• High School Diploma or GED is required.
• 1 year claim billing or processing experience preferred.
• Strong verbal and written communication skills.
• Ability to navigate multiple systems simultaneously.
• Knowledge of administrative and clerical procedures related to claims processing.

Responsabilidades

• Receives and processes claims data; verifies information.
• Determines benefit eligibility and final payment after reviews.
• Escalates issues to supervision and maintains professional communication with customers.
• Meets production and quality standards and keeps accurate records.
• Performs other duties as assigned.

Conocimientos

Claims processing

Attention to detail

Communication skills

Analytical thinking

Multi-system navigation

Educación

High School Diploma/GED

Descripción del empleo

Highmark Inc. is seeking a remote claims processor to screen, review, and adjudicate online and paper/electronic claims.

You will determine if claims should be returned, denied, or paid, following established policies and procedures. The role involves correcting errors, coordinating benefits, and communicating with customers while maintaining timely and accurate work, supported by standard HIPAA and privacy guidelines.