Thryve Digital Recruitment Drive 2023
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Basic Qualifications
Bachelor’s degree or Master’s degree
Eligibility & Skills
The job position offered requires the successful candidate to take the lead in providing complex claims adjudication services as part of an Operations team.
Claims Adjudicators are responsible for analyzing, validating, updating, processing, and adjudicating claims while ensuring compliance with Highmark standards and policies.
To be eligible for the program, an individual must meet the following requirements:
They provide general support to maintain TAT, meet SLAs, and achieve required performance and quality levels.
The Claims Adjudicator may also mentor less experienced team members.
The essential responsibilities of the job include analyzing, validating, updating, and processing claims while meeting defined scope, targets, and SLAs.
The role requires collaboration with customers, business analysts, partners, and IT team members to understand business requirements that drive innovation and quality.
Claims Adjudicators concentrate on providing innovative solutions to more complex business needs.
The job also entails providing support to new joiners once they gain experience, performing work in compliance with all Highmark and Highmark IT standards, policies, and procedures, and effectively communicating with team members, customers, partners, and management, including assisting with or conducting complex walkthroughs, reporting production, and quality status. Other duties may be assigned or requested.
To be considered for the position, candidates must possess a Bachelor’s or Master’s degree in any discipline, good verbal and written skills, and good analytical and interpersonal skills.
All work must be performed while complying with all Highmark and Highmark IT standards, policies, and procedures.
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