Remote Claims Adjudicator

Highmark Health; City of Albany (NY); Remote; USD 27,000 - 33,000; Full time

Job summary

Highmark Inc. is seeking a claims examiner to screen, review, and adjudicate online claims. You will determine eligibility, process adjustments, and resolve inquiries while following policies and procedures.

This remote role supports timely, accurate claim decisions and requires strong communication and analytical skills. Base pay is $19.39–$24.19 per hour, with opportunities to grow through training and cross-functional collaboration.

Qualifications

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

Responsibilities

• Receives and processes claims to verify data.
• Determines eligibility and final payment levels.
• Elevates issues to supervision and communicates with customers.
• Meets production and quality standards and maintains records.
• Performs other duties as assigned.

Skills

Communication skills

Data analysis

Multi-system navigation

Math for adjudication

Problem solving

Claim processing systems

Record keeping

HIPAA awareness

Education

High School Diploma or GED

Job description

Highmark Inc. is seeking a claims examiner to screen, review, and adjudicate online claims. You will determine eligibility, process adjustments, and resolve inquiries while following policies and procedures.

This remote role supports timely, accurate claim decisions and requires strong communication and analytical skills. Base pay is $19.39–$24.19 per hour, with opportunities to grow through training and cross-functional collaboration.