Remote Healthcare Claims Adjuster

Highmark Health Company; United States; Remote; USD 47.000 - 48.000; Vollzeit

Zusammenfassung

Highmark Health is seeking a Claims Reviewer to provide complete, accurate, and timely review and adjustments of Blue Card claims. This role participates in a union-based setting and requires residence in specified NY counties.

Candidates should have healthcare or insurance experience with claims processing and knowledge of medical terminology. Emphasis on confidentiality, professional service, and accurate documentation in daily operations.

Qualifikationen

• Healthcare or insurance related experience; claims processing experience; knowledge of medical terminology.
• Preferred: Previous claims processing or equivalent experience.
• High School/GED required; no specific certifications listed.

Aufgaben

• Adjusts Blue Card claims under contracts and procedures via online transactions and system adjustments.
• Identifies potential fraudulent cases and forwards to Special Investigations for review.
• Responds to inquiries from internal and external customers and maintains production records.
• Maintains HIPAA confidentiality and delivers professional customer service.
• Performs duties efficiently and as assigned.

Kenntnisse

Claims processing

Healthcare experience

HIPAA knowledge

Attention to detail

Ausbildung

High School/GED

Jobbeschreibung

Highmark Health is seeking a Claims Reviewer to provide complete, accurate, and timely review and adjustments of Blue Card claims. This role participates in a union-based setting and requires residence in specified NY counties.

Candidates should have healthcare or insurance experience with claims processing and knowledge of medical terminology. Emphasis on confidentiality, professional service, and accurate documentation in daily operations.