Claims Processor II

🔥 17 hours ago

🐻 Alaska, Arizona, +25 more states – Remote

🐻 Alaska – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🌲 North Carolina – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote ☕ Washington – Remote 🧀 Wisconsin – Remote

💵 $41.5k - $62.3k / year

⏰ Full Time

🟢 Junior

📋 Claims Specialist

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Premera Blue Cross

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1945

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Premera Blue Cross is an independent health insurance provider, serving businesses and residents of Washington State and Alaska as a licensee of the Blue Cross Blue Shield Association. The company offers a range of health plans including individual, family, employer-based, and Medicare Supplement plans. However, it has announced that it will exit the Medicare Advantage market as of January 1, 2025. Premera is committed to advancing health equity and community support, evident through its Social Impact Program focused on behavioral health and homelessness solutions in Washington and Alaska. Additionally, Premera complies with federal and state civil rights laws, offering language assistance services to ensure equitable care.

📋 Description

• Review, process, and resolve moderately complex claims in accordance with contracts and policies. • Research claims using reference materials and online tools. • Accurately code claims through the system. • Translate data into information acceptable to the claims processing system and follow up on pended claims. • Maintain claims files and perform follow-up on pended claims. • Prepare claims for return to providers or subscribers when additional information is needed. • Demonstrate adjudication proficiency to meet or exceed accuracy goals. • Meet cycle time and productivity goals aligned with corporate objectives. • Maintain confidentiality of documents and files. • Contact other carriers or provider offices as necessary. • Provide buddy training and feedback to new associates when needed. • Complete adjustments, reversals, and/or refunds when needed. • Apply quality practices to prevent defects and internal rework.

🎯 Requirements

• High School diploma or GED (Required). • Six (6) months of claims processing experience or customer service experience (Required). • Experience with Out-of-area program. • Technical experience of contract benefits, claims processing steps, and correction procedures.

🏖️ Benefits

• Medical, vision, and dental coverage with low employee premiums. • Voluntary benefit offerings, including pet insurance for paw parents. • Life and disability insurance. • Retirement programs, including a 401K employer match and a pension plan vested after 3 years of service. • Wellness incentives with mental well-being resources, counseling services, stress management programs, and mindfulness programs. • Generous paid time off. • Tuition assistance for undergraduate and graduate degrees. • Employee recognition program. • On-campus flexibility, on-site resources, networking opportunities, and team engagement for hybrid employees. • Commuter perks. • Free convenient on-site parking. • Subsidized on-campus cafes. • Engaging on-site health and wellness activities. • Fitness and well-being center with in-person and virtual workouts and nutritional counseling.