Remote Claims Adjudication Specialist

Highmark Health; Juneau (AK); Remote; USD 27,000 - 33,000; Full time

Job summary

Highmark Inc. is seeking a remote claims processor to screen, review, and adjudicate online and paper claims, ensuring accurate data entry and timely pay decisions. The role supports audits and requires strong attention to detail and HIPAA compliance.

Required is a High School Diploma/GED, with a preference for 1 year of claim billing or processing experience. You will work across multiple systems, maintain records, and contribute to quality assurance programs and training.

Qualifications

• High school diploma or GED required.
• Prefer 1 year of claim billing or processing experience.
• Ability to process and adjudicate claims accurately.

Responsibilities

• Enter and verify claims data for completeness.
• Determine benefit eligibility and final payment amounts.
• Elevate issues to supervision and maintain professional communication.
• Meet production and quality standards and maintain records.
• Perform other duties as assigned.

Skills

Communication skills

Multi-system navigation

Clerical procedures

Mathematics for adjudication

Problem solving

Claims processing systems

Education

High School Diploma/GED

Job description

Highmark Inc. is seeking a remote claims processor to screen, review, and adjudicate online and paper claims, ensuring accurate data entry and timely pay decisions. The role supports audits and requires strong attention to detail and HIPAA compliance.

Required is a High School Diploma/GED, with a preference for 1 year of claim billing or processing experience. You will work across multiple systems, maintain records, and contribute to quality assurance programs and training.