Remote Claims Adjudicator

Highmark Health; Heber (UT); Remote; USD 27,000 - 33,000; Full time

Job summary

Highmark Inc. is seeking a claims processing professional for remote work. The role involves screening, reviewing, and adjudicating online and paper/electronic claims, ensuring accuracy, and applying organizational policies for pay or denial decisions.

Responsibilities include entering data, verifying completeness, resolving edits, and communicating with customers. Requires a high school diploma and preferred 1 year of claims experience.

Qualifications

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

Responsibilities

• Process and verify claims data for completeness.
• Determine eligibility and final payment amounts.
• Escalate issues to supervisors as needed.
• Maintain accurate records and complete required training.
• Perform other duties as assigned.

Skills

Communication skills

Follow directions

Admin procedures

Math for claims

Problem solving

Claim processing OS

Claims data analysis

Reading benefits & edits

Education

High School Diploma/GED

Job description

Highmark Inc. is seeking a claims processing professional for remote work. The role involves screening, reviewing, and adjudicating online and paper/electronic claims, ensuring accuracy, and applying organizational policies for pay or denial decisions.

Responsibilities include entering data, verifying completeness, resolving edits, and communicating with customers. Requires a high school diploma and preferred 1 year of claims experience.