Remote Claims Processor: Quick Adjudication & QA

Highmark Health; Lincoln (NE); 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 claims. This remote role requires attention to detail, strong data entry, and the ability to navigate multiple systems efficiently.

You will determine benefit eligibility, resolve claim edits, and communicate professionally with customers while meeting production and quality standards. Prior claim processing experience is preferred.

Qualifications

• Screening, reviewing, and adjudicating online claims.
• Requires attention to detail and accuracy.
• Familiarity with benefit interpretation and edits.

Responsibilities

• Receives and processes claims, entering/verifying data.
• Resolves claim edits and determines benefit eligibility.
• Maintains professional communication with customers.
• Meets production and quality standards; maintains records and timekeeping.
• Performs other duties as assigned.

Skills

Verbal communication

Written communication

System navigation

Word processing

Records management

Math for claims

Problem solving

Claim processing systems

Data analysis

Education

High School Diploma/GED

Tools

Claims processing systems

Job description

Highmark Inc. is seeking a Claims Processor to screen, review, and adjudicate online and paper claims. This remote role requires attention to detail, strong data entry, and the ability to navigate multiple systems efficiently.

You will determine benefit eligibility, resolve claim edits, and communicate professionally with customers while meeting production and quality standards. Prior claim processing experience is preferred.