Remote Claims Adjudication Specialist

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

Job summary

Highmark Health is seeking a Claims Adjudicator to screen, review, and adjudicate online and paper claims. You will correct errors, determine pay/deny decisions, and ensure timely processing in line with policies.

Responsibilities include entering claims data, resolving edits, verifying eligibility, communicating with customers, and maintaining accurate records. A high school diploma is required, with preference for 1 year billing experience.

Qualifications

• High School Diploma or GED required.
• Experience in claim billing preferred.
• Ability to handle sensitive information with confidentiality.

Responsibilities

• Enter and verify claims data for completeness and correctness.
• Resolve edits and determine benefit eligibility and final payment.
• Communicate with customers and escalate issues as needed.
• Maintain accurate records including timekeeping and documentation.

Skills

Communication skills

Data entry

Claims processing

Problem solving

Analytical skills

HIPAA compliance

Education

High School Diploma/GED

Job description

Highmark Health is seeking a Claims Adjudicator to screen, review, and adjudicate online and paper claims. You will correct errors, determine pay/deny decisions, and ensure timely processing in line with policies.

Responsibilities include entering claims data, resolving edits, verifying eligibility, communicating with customers, and maintaining accurate records. A high school diploma is required, with preference for 1 year billing experience.