Remote Claims Adjudicator

Highmark Health; Montana City (MT); Remote; USD 27,000 - 33,000; Full time

Job summary

Highmark Inc. is seeking a claims processor to screen, review, and adjudicate paper/electronic claims. You will verify data, determine eligibility, and adjust payments as needed while following policies and procedures. The role emphasizes accuracy, timely processing, and professional interaction with customers.

The position requires strong communication, ability to navigate multiple systems, and knowledge of claims processing. Remote work is offered, with pay range disclosed per hour.

Qualifications

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

Responsibilities

• Receives and processes claims data; verifies completeness and accuracy.
• Resolves edits and determines benefit eligibility and final payment.
• Escalates issues to supervision and maintains professional communication with customers.

Skills

strong communication

multi-system navigation

administrative procedures

mathematics for adjudication

problem solving

claims processing knowledge

data review

Education

High School Diploma/GED

Job description

Highmark Inc. is seeking a claims processor to screen, review, and adjudicate paper/electronic claims. You will verify data, determine eligibility, and adjust payments as needed while following policies and procedures. The role emphasizes accuracy, timely processing, and professional interaction with customers.

The position requires strong communication, ability to navigate multiple systems, and knowledge of claims processing. Remote work is offered, with pay range disclosed per hour.