Remote Claims Adjudicator

Highmark Health; Bastrop (LA); Remote; USD 27,000 - 33,000; Full time

Job summary

Highmark Inc. is seeking a Claims Processor to screen, review, and adjudicate online and paper/electronic claims, ensuring accuracy and timely processing in a remote setting.

The role involves correcting errors, researching inquiries, and applying enrollment and benefit data to determine final payment decisions. The position requires attention to detail, ability to work across multiple systems, and strong communication skills to interact with customers and internal teams.

Qualifications

• Requires high school diploma or GED.
• 1 year claim billing or processing experience preferred.
• Ability to navigate multiple systems and analyze data.

Responsibilities

• Receives and processes claims and verifies data.
• Determines benefit eligibility and final payment.
• Escalates issues to supervisors and maintains professional communication with customers.

Skills

Verbal communication

Written communication

System navigation

Data analysis

Mathematics for adjudication

Problem solving

Operating systems for claims

Education

High School Diploma/GED

Job description

Highmark Inc. is seeking a Claims Processor to screen, review, and adjudicate online and paper/electronic claims, ensuring accuracy and timely processing in a remote setting.

The role involves correcting errors, researching inquiries, and applying enrollment and benefit data to determine final payment decisions. The position requires attention to detail, ability to work across multiple systems, and strong communication skills to interact with customers and internal teams.