Claims Processor

Highmark Health

Claims Processor responsible for processing and reviewing paper/electronic claims for United Concordia Dental. Ensures accuracy, resolves issues, and meets production standards in a remote role.

Posted 4/30/2026full-timeRemote • Louisiana, Maryland, North Carolina, Pennsylvania, Washington • 🇺🇸 United StatesJuniorMid-Level💰 $18 - $22 per hourWebsite

About the role

Key responsibilities & impact

Receives and processes claims including entering/verifying claims data; determines if claim information is complete and correct.
Resolves claim edits, reviews history records and determines benefit eligibility for service.
Reviews payment levels to arrive at final payment determination; elevates issues to next level of supervision, as appropriate.
Meets all production and quality standards, ensuring timeliness and accuracy of all work.
Maintains accurate records including timekeeping records.
Attends all required training classes.

Requirements

What you’ll need

High School Diploma/GED
Ability to take direction and navigate through multiple systems simultaneously.
Knowledge of administrative and clerical procedures and systems such as word processing and managing files and records.
Ability to use mathematics to adjudicate claims.
Ability to solve problems within pre-defined methods and guidelines.
Knowledge of operating systems specific to claim processing.
Ability to thoroughly read guidelines ensuring claim accuracy and following directions.

Benefits

Comp & perks

Health insurance
401(k) matching
Paid time off
Remote work options

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

claims processingdata entrybenefit eligibility determinationpayment determinationmathematics for claims adjudicationadministrative proceduresclerical proceduresrecord managementoperating systems for claim processing

Soft Skills

problem-solvingattention to detailability to take directiontimelinessaccuracynavigating multiple systemsfollowing directions

Certifications

High School DiplomaGED