Remote Healthcare Claims Adjuster (Blue Card)

Highmark Health; New York (NY); Hybrid; USD 30,000 - 34,000; Full time

Job summary

Highmark Inc. seeks a claims reviewer to provide complete and accurate claims review and perform adjustments related to Blue Card claims administration. This bargaining unit role requires residence in specified New York counties per the CBA.

The candidate should have healthcare or insurance-related experience, knowledge of medical terminology, and strong typing and multitasking skills. The role emphasizes confidentiality and professional customer service.

Qualifications

• Healthcare or insurance related experience; claims processing; knowledge of medical terminology.
• Basic computer literacy; 30 WPM typing; and Job Content testing.

Responsibilities

• Adjusts Blue Card claims under contracts and procedures using the claims system.
• Identifies potential fraudulent cases and forwards to Special Investigations.
• Initiates correspondence and/or telephone contact related to claims administration/adjustments.
• Answers inquiries from internal and external customers.
• Maintains confidentiality and HIPAA compliance.
• Delivers service in a professional, polite, and efficient manner.
• Performs duties efficiently and at an acceptable rate.
• Other duties as assigned.

Skills

Typing 30 WPM

Multitasking

Organization

English proficiency

Office equipment

Problem solving

Education

High School/GED

Job description

Highmark Inc. seeks a claims reviewer to provide complete and accurate claims review and perform adjustments related to Blue Card claims administration. This bargaining unit role requires residence in specified New York counties per the CBA.

The candidate should have healthcare or insurance-related experience, knowledge of medical terminology, and strong typing and multitasking skills. The role emphasizes confidentiality and professional customer service.