Remote Claims Adjudication Specialist

Highmark Health; Helena (MT); Teletrabalho; USD 27 000 - 33 000; Tempo integral

Resumo da oferta

Highmark Inc. is seeking a detail-oriented claims processor to review and adjudicate online and paper claims from remote locations.

You will verify data, correct errors, determine eligibility, and apply policy guidelines to decide pay, deny, or return claims, while coordinating with customers and internal teams. The role requires a High School Diploma or GED and prefers about 1 year of claim billing or processing experience; strong communication and math skills are essential in this fast-paced

Qualificações

• High School Diploma or GED required.
• One year claim billing or processing experience preferred.
• Strong communication and organization skills.
• Ability to work remotely and use multiple systems simultaneously.

Responsabilidades

• Process and verify claims data for completeness.
• Determine if claim information is complete and correct; resolve edits.
• Coordinate with customers and escalate issues as needed.
• Maintain timekeeping and training records; meet quality standards.
• Perform other duties as assigned.

Conhecimentos

Communication

System navigation

Administrative procedures

Mathematics for claims

Problem solving

Claim processing OS

Data analysis

Benefits review

Formação académica

High School Diploma/GED

Descrição da oferta de emprego

Highmark Inc. is seeking a detail-oriented claims processor to review and adjudicate online and paper claims from remote locations.

You will verify data, correct errors, determine eligibility, and apply policy guidelines to decide pay, deny, or return claims, while coordinating with customers and internal teams. The role requires a High School Diploma or GED and prefers about 1 year of claim billing or processing experience; strong communication and math skills are essential in this fast-paced