Remote Claims Adjudication Specialist

Highmark Health; Minnesota; Remote; USD 27,000 - 33,000; Full time

Job summary

Highmark Health is seeking a claims processing professional to screen, review, and adjudicate online and paper claims. This role includes correcting errors, determining pay or denial, and coordinating with customers where needed. The candidate will use enrollment, benefit, and claim history data to finalize actions.

Remote position within the United States. Strong communication, data handling, and problem-solving skills are essential to ensure accurate, timely processing and compliance with

Qualifications

• High School Diploma or GED required.
• 1 year claim billing or processing experience preferred.

Responsibilities

• Process and enter claims data, verify completeness and correctness.
• Resolve claim edits and determine benefit eligibility.
• Communicate professionally with internal and external customers.
• Meet production and quality standards and maintain accurate records.

Skills

Verbal communication

Written communication

Multi-system navigation

Administrative procedures

Math for adjudication

Problem solving

Claims review and analysis

Education

High School Diploma/GED

Job description

Highmark Health is seeking a claims processing professional to screen, review, and adjudicate online and paper claims. This role includes correcting errors, determining pay or denial, and coordinating with customers where needed. The candidate will use enrollment, benefit, and claim history data to finalize actions.

Remote position within the United States. Strong communication, data handling, and problem-solving skills are essential to ensure accurate, timely processing and compliance with