Claims Adjuster I responsible for investigating physical damage claims on vehicles. Working under Claims Supervisor to evaluate, settle, or deny claims in Omaha, Nebraska office.
About the role
- Claims Processor at Highmark overseeing claims adjustments and inquiries. Responsible for processing complex claims and ensuring timely resolution of payment determinations.
Responsibilities
- Screening, reviewing, evaluating online entry, correcting errors and/or performing quality control review and final adjudication of paper/electronic claims.
- Determines whether to return, deny or pay claims following organizational policies and procedures.
- Reviews processed claims and inquiries to determine corrective action including adjusting claims as necessary.
- Responsible for the timely and accurate completion of claims adjustments which could be a result of internal/external audits, member/provider phone calls, other insurance information received, appeals, and system changes.
Requirements
- High School Diploma/GED
- 3 years of related experience
- 1 year of claims processing experience
- Knowledge to research and handle complex claims
Benefits
- Health insurance
- Professional development opportunities
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