Remote Claims Adjudication Specialist

Highmark Health; Harrisburg (Dauphin County); Remote; USD 27.000 - 33.000; Vollzeit

Zusammenfassung

Highmark Inc. is seeking a claims processing specialist to screen, review, and adjudicate online and paper/electronic claims. You will verify data, correct errors, determine eligibility, and apply organizational policies to decide pay, deny, or return actions.

This remote role requires strong communication, accuracy, and the ability to navigate multiple systems. Salary ranges from $19.39 to $24.19 per hour, with HIPAA/privacy compliance.

Qualifikationen

• High School Diploma or GED required.
• 1 year claim billing or processing experience preferred.
• Experience with claims processing systems and data entry is desirable.

Aufgaben

• Enter and verify claims data; determine completeness and accuracy.
• Resolve claim edits and determine benefit eligibility and final payment.
• Escalate issues to supervision and maintain professional communication with customers.
• Meet production and quality standards and maintain accurate timekeeping and records.
• Perform additional duties as assigned.

Kenntnisse

Attention to detail

Verbal communication

Data entry

Problem solving

System navigation

Claims review

Analytical thinking

Researching claims

Ausbildung

High School Diploma/GED

Jobbeschreibung

Highmark Inc. is seeking a claims processing specialist to screen, review, and adjudicate online and paper/electronic claims. You will verify data, correct errors, determine eligibility, and apply organizational policies to decide pay, deny, or return actions.

This remote role requires strong communication, accuracy, and the ability to navigate multiple systems. Salary ranges from $19.39 to $24.19 per hour, with HIPAA/privacy compliance.