Remote Claims Specialist: Adjudication & Payments

Highmark Health; Bismarck (ND); Remote; USD 27,000 - 33,000; Full time

Job summary

Highmark Inc. seeks a Claims Processor to review and adjudicate health care claims. You will verify data, determine eligibility, correct errors, and finalize payments in line with policy. This remote role requires accuracy and timely processing.

Responsibilities include entering claims data, resolving edits, and supporting customers while meeting production standards. Pay ranges from $19.39 to $24.19 per hour, with base pay reflecting experience and location. HIPAA compliance is required.

Qualifications

• High School Diploma/GED required.
• Experience with claim billing or processing preferred.

Responsibilities

• Receives and processes claims; enters/verifies data and ensures completeness.
• Resolves edits and determines benefit eligibility and final payment.
• Escalates issues as needed and maintains professional communication with customers.
• Meets production and quality standards and maintains accurate timekeeping and records.
• Performs other duties as assigned.

Skills

Strong verbal and written comms

Take direction

Admin procedures

Mathematics for adjudication

Problem solving

Operating systems know-how

Review and analyze claims

Read benefits and edits

Research and finalize claims

Education

High School Diploma/GED

Job description

Highmark Inc. seeks a Claims Processor to review and adjudicate health care claims. You will verify data, determine eligibility, correct errors, and finalize payments in line with policy. This remote role requires accuracy and timely processing.

Responsibilities include entering claims data, resolving edits, and supporting customers while meeting production standards. Pay ranges from $19.39 to $24.19 per hour, with base pay reflecting experience and location. HIPAA compliance is required.