claims processor

Moda Health

<div><p><b>Let&rsquo;s do great things, together!</b></p><p><b>
About Moda</b><br>
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we&rsquo;re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let&rsquo;s be better together.</p><p><b><br>
Position Summary</b><br>
Responsible for timely and accurate payment of Commercial and Medicaid inpatient hospital claims. Answer internal questions from various departments and respond to correspondence from providers when necessary. <b>This is a FT WFH role.</b><br>
<br>
<b>Pay Range</b><br>
$21.30 - $23.96 hourly (depending on experience) *Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.</p><p><b><br>
Please fill out an application on our company page, linked below, to be considered for this position.</b></p><p>
https://j.brt.mv/jb.do?reqGK=27772651&amp;refresh=true</p><p><b><br>
Benefits</b><b>:</b></p><ul><li>
Medical, Dental, Vision, Pharmacy, Life, &amp; Disability</li><li>
401K- Matching</li><li>
FSA</li><li>
Employee Assistance Program</li><li>
PTO and Company Paid Holidays</li></ul><p></p><p><b><br>
Required Skills, Experience &amp; Education:</b></p><ul><li>
High School diploma or equivalent.</li><li>
1-2 years medical claims processing experience.</li><li>
10-key proficiency of 135 wpm.</li><li>
Type a minimum of 35 wpm.</li><li>
Knowledge of medical terminology, CPT codes and ICD-10 codes.</li><li>
Strong verbal, written, and interpersonal communication skills.</li><li>
Analytical, problem solving and organizational skills.</li><li>
Ability to work well under pressure.</li><li>
Maintain confidentiality and project a professional business image</li><li>
Ability to maintain balanced performance in areas of production and quality.</li></ul><p><b><br>
Primary Functions</b><b>:</b></p><ul><li>
Review, process and adjust Commercial and Medicaid inpatient claims.
</li><li>Review claims data, interpreting coding and understanding medical terminology in relation to diagnosis and procedures.</li><li>
Review, analyze, price, and resolve inpatient claims through the utilization of available resources for moderate to complex inpatient claims, adjustments, and file reviews.
</li><li>Process Commercial and Medicaid inpatient claims for all types of contracts (e.g., DRG, per diem, case rate, % of CMS).
</li><li>Analyze and apply plan concepts to claims that include deductible, coinsurance, copay out of pocket, etc.
</li><li>Examine claims to determine if further investigation is needed from other departments and routes claims appropriately through the system.
</li><li>Contact providers and other outside sources for additional information.</li><li>
Adjudicate claims to achieve quality and production standards applicable to the position.</li><li>
Release claims by deadlines to meet company, state regulations, contractual agreements, and group performance guarantee standards.</li><li>
Review Policy and Procedures (P&amp;P) for process instructions to ensure accurate and efficient claims processing as well as providing suggestions for potential process improvements.</li><li>
Perform all job functions with a high degree of discretion and confidentiality in compliance with federal, state, and departmental confidentiality guidelines.</li><li>
Perform other duties as assigned.</li></ul><p><b><br>
Working Conditions &amp; Contact with Others</b></p><ul><li>
Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 37.5 hours per week, including evenings and occasional weekends, to meet business need.</li><li>
Works internally with Healthcare Services, Membership Accounting, Customer Service, Hospital Auditors, Provider Correspondence, and Professional Relations. Works externally with providers and vendors.</li></ul><p><b><br>
Together, we can be more. We can be better.</b><br>
<br>
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.<br>
<br>
For more information regarding accommodations please direct your questions to Kristy Nehler and Danielle Baker via our humanresources@modahealth.com email.</p></div>

Inpatient Claims Processor I

NTT DATA

<div>NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team.
<br>
In this Role the candidate will be responsible for:<br>
<ul><li>Processing of Professional claim forms files by provider</li><li>Reviewing the policies and benefits</li><li>Comply with company regulations regarding HIPAA, confidentiality, and PHI</li><li>Abide with the timelines to complete compliance training of NTT Data/Client</li><li>Work independently to research, review and act on the claims</li><li>Prioritize work and adjudicate claims as per turnaround time/SLAs</li><li>Ensure claims are adjudicated as per clients defined workflows, guidelines</li><li>Sustaining and meeting the client productivity/quality targets to avoid penalties</li><li>Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.</li><li>Timely response and resolution of claims received via emails as priority work</li><li>Correctly calculate claims payable amount using applicable methodology/ fee schedule</li></ul><br>
Requirements:<br>
<ul><li>3 year(s) hands-on experience in Healthcare Claims Processing</li><li>2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools</li><li>High school diploma or GED.</li><li>Previously performing - in P&amp;Q work environment; work from queue; remotely</li><li>Key board skills and computer familiarity -</li></ul>
o Toggling back and forth between screens/can you navigate multiple systems.<br>
o Working knowledge of MS office products - Outlook, MS Word and MS-Excel.<br>
<br>
Preferred Skills &amp; Experiences:<br>
<ul><li>Amisys</li><li>Ability to communicate (oral/written) effectively in a professional office setting</li><li>Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities</li><li>Time management with the ability to cope in a complex, changing environment</li></ul></div>

Medical Claims Processor, Remote Temporary

<div>At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.<br>
<br>
For more than 25 years, NTT DATA Services have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.<br>
<br>
NTT DATA Services currently seeks Xcelys Medical Claims Examinersto join our team remotely for a 6-12 month contract role.<br>
<br>
<b>MUST HAVE XCELYS EXPERIENCE</b><br>
<br>
To serve as a Medical Claims Processor within the Xcelys environment. Provide subject-matter expertise on claims workflows and be a key contributor to system enhancements, audits, and process optimizations.<br>
<br>
<b>Role Responsibilities:</b>
<div><ul><li>Adjudication &amp; Review</li></ul>
</div><ul><li>Process comprehensive medical claims using Xcelys and associated subsystems</li>
<li>Resolve complex pends, coding issues, and contract exceptions</li>
<li>Author overpayment/underpayment determinations and coordinate appeals</li></ul>
<div><ul><li>Quality &amp; Compliance</li></ul>
</div><ul><li>Engage in quality reviews, audits, root cause analyses</li>
<li>Monitor accuracy, variance, and rework metrics</li>
<li>Ensure alignment with regulatory and internal compliance guidelines</li></ul>
<div><ul><li>Support</li></ul>
</div><ul><li>Act as escalation point and subject matter expert</li></ul>
<div><ul><li>Process &amp; System Improvement</li></ul>
</div><ul><li>Participate in system testing, UAT, and workflow enhancements</li>
<li>Recommend improvements, document system and process changes</li></ul>
<div><ul><li>Reporting &amp; Analytics</li></ul>
</div><ul><li>Prepare production, pending, and quality reports</li>
<li>Identify trends and recommend corrective actions</li></ul>
<div><ul><li>Cross-Functional Collaboration</li></ul>
</div><ul><li>Liaise with provider relations, legal, IT, compliance teams</li>
<li>Support internal initiatives related to claims systems / operational improvements</li></ul><br>
<b>
Required Skills/Experience
</b><ul><li>5+ years claims adjudication experience</li>
<li>Minimum of 1 year experience in Xcelys
</li><li>2+ years in coding (CPT, ICD-10, HCPCS)</li>
<li>2+ years provider contracts, pricing, regulatory guidelines experience</li></ul>
<b>Preferences</b>
<ul><li>Excellent analytical and communication skills</li>
<li>Experience training staff or acting as a mentor</li>
<li>Familiarity with system testing and documentation</li>
<li>Ability to manage high-volume workload and meet performance metrics</li></ul>
<b>Education: Verifiable high school diploma or GED</b><br>
<br>
About NTT DATA Services:<br>
<br>
NTT DATA Services is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success. Visit nttdata.com or LinkedIn to learn more.<br>
<br>
NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.<br>
<br>
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is <b>($20/hourly )</b>. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.<br>
<br>
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&amp;D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.</div>

Xcelys Medical Claims Examiner

<div>At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.<br>
<br>
For more than 25 years, NTT DATA Services have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.<br>
<br>
<b>Claims Examiner-Xcelys </b><b>Location: Fully Remote</b> <b>Pay Rate: $20.00 Per hour</b> <b>Start Date: 4/13/2026</b> <b>M-F 8:00am-5pm CT.</b> <b>Employment Type: Long Term Contract/Not Direct Hire</b><br>
<br>
<b>MUST HAVE XCELYS EXPERIENCE</b><br>
<br>
To serve as a Medical Claims Processor within the Xcelys environment. Provide subject-matter expertise on claims workflows and be a key contributor to system enhancements, audits, and process optimizations.<br>
<br>
<b>Role Responsibilities:</b>
<div><ul><li>Adjudication &amp; Review</li></ul>
</div><ul><li>Process comprehensive medical claims using Xcelys and associated subsystems</li>
<li>Resolve complex pends, coding issues, and contract exceptions</li>
<li>Author overpayment/underpayment determinations and coordinate appeals</li></ul>
<div><ul><li>Quality &amp; Compliance</li></ul>
</div><ul><li>Engage in quality reviews, audits, root cause analyses</li>
<li>Monitor accuracy, variance, and rework metrics</li>
<li>Ensure alignment with regulatory and internal compliance guidelines</li></ul>
<div><ul><li>Support</li></ul>
</div><ul><li>Act as escalation point and subject matter expert</li></ul>
<div><ul><li>Process &amp; System Improvement</li></ul>
</div><ul><li>Participate in system testing, UAT, and workflow enhancements</li>
<li>Recommend improvements, document system and process changes</li></ul>
<div><ul><li>Reporting &amp; Analytics</li></ul>
</div><ul><li>Prepare production, pending, and quality reports</li>
<li>Identify trends and recommend corrective actions</li></ul>
<div><ul><li>Cross-Functional Collaboration</li></ul>
</div><ul><li>Liaise with provider relations, legal, IT, compliance teams</li>
<li>Support internal initiatives related to claims systems / operational improvements</li></ul><br>
<b>
Required Skills/Experience
</b><ul><li>2+ years claims adjudication experience</li>
<li>Minimum of 1 year experience in Xcelys
</li><li>2+ years in coding (CPT, ICD-10, HCPCS)</li>
<li>2+ years provider contracts, pricing, regulatory guidelines experience</li></ul>
<b>Preferences</b>
<ul><li>Excellent analytical and communication skills</li>
<li>Experience training staff or acting as a mentor</li>
<li>Familiarity with system testing and documentation</li>
<li>Ability to manage high-volume workload and meet performance metrics</li></ul>
<b>Education: Verifiable high school diploma or GED</b><br>
<br>
About NTT DATA Services:<br>
<br>
NTT DATA Services is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success. Visit nttdata.com or LinkedIn to learn more.<br>
<br>
NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.<br>
<br>
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is <b>($20/hourly )</b>. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.<br>
<br>
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&amp;D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.</div>

Xcelys Medical Claims Examiner (Remote)

UnitedHealthcare

<div><p><i>This position is Onsite. Our office is located at 115 W WAUSAU AVE, WAUSAU, 54401.</i></p><p><b>
UMR, UnitedHealthcare's</b> third-party administrator (TPA) solution, is the nation's largest TPA. When you work with<b> UMR,</b> what you do matters. It's that simple . . . and it's that rewarding.</p><p>
In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within <b>UMR </b>due to our record-breaking growth.</p><p>
Regardless of your role at <b>UMR</b>, the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast-paced and highly diversified career.</p><p>
This position is full time (40 hours / week), Monday - Friday. Employees have the flexibility to work an 8-hour shift schedule during our normal business hours of 7:00am - 8:00pm CST. It may be necessary, given the business need, to work occasional overtime.</p><p>
We offer 9 weeks of paid training. The hours during training will be 8:00am to 4:30pm CST, Monday - Friday. Training will be conducted onsite.</p><p><br>
</p><p><b>Primary Responsibilities:</b></p><ul><li>
Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims</li><li>
Analyze and identify trends and provide reports as necessary</li><li>
Consistently meet established productivity, schedule adherence and quality standards</li></ul><p>
This is a challenging role that takes an ability to thoroughly review, analyze and research complex health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy, which will impact the timely processing of the member's claim.</p><p><br>
</p><p>You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.</p><p><b>
Required Qualifications:</b></p><ul><li>
High School Diploma / GED OR equivalent work experience</li><li>
Must be 18 years of age OR older</li><li>
Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications</li><li>
This position is onsite at 115 W WAUSAU AVE, WAUSAU, 54401, candidates must be able to work full time at this role.</li><li>
Ability to work full time (40 hours / week), Monday - Friday. Employees have the flexibility to work an 8-hour shift schedule during our normal business hours of 7:00am - 8:00pm CST. It may be necessary, given the business need, to work occasional overtime.</li></ul><p><br>
</p><p><b>Preferred Qualifications:</b></p><ul><li>
1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools</li><li>
1+ years of experience with processing medical, dental, prescription, OR mental health claims</li></ul><p><br>
</p><p>Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $17.98 - $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable.</p><p><br>
</p><p><i>At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.</i></p><p></p><p><i><br>
</i></p><p><i>UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.</i></p><p><i><br>
</i></p><p><i>UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.</i></p><p><br>
</p><p>#RPO #RED #RPOLinkedIn</p></div>

Claims Representative

MPF Federal

<div><p>The Dental Claims Resolution Specialist I is responsible for entering and processing dental claims in the claims system. This role requires attention to detail, strong problem-solving skills, and the ability to follow established guidelines to ensure claims are processed accurately and on time.</p><p><b>
Compensation: Pursuant to Service Contract Act - Starting at $17.00</b></p><p>
You will review claim submissions, enter claim information into the system, identify errors or missing information, and help ensure claims move through the process efficiently.</p>
Key Responsibilities<ul><li>
Enter dental claim information into the claims processing system from paper, portal, or fax submissions
</li><li>Review claims for accuracy and correct OCR or data entry errors
</li><li>Monitor and respond to questions from the claims email queue
</li><li>Assist with resolving claims that fail electronic processing (EDI errors)
</li><li>Track claims issues using spreadsheets to ensure claims are processed within required timelines
</li><li>Research and resolve moderately complex claims issues
</li><li>Follow the full claim lifecycle to ensure claims are processed and resolved properly
</li><li>Communicate with internal teams to resolve claim issues when needed</li></ul>
Work Environment<ul><li>
<b>Fully remote position (U.S.-based employees only)</b>
</li><li>Work hours will be communicated during the hiring process
</li><li>Company equipment and systems will be provided for performing job duties</li></ul><br>
<b>
Requirements</b><br>
<br>
Required Qualifications<ul><li>
At least <b>3 years of claims processing or related experience</b> (dental experience preferred)
</li><li>Strong attention to detail and problem-solving skills
</li><li>Proficiency with <b>Microsoft Office (Excel, Word, Outlook)</b>
</li><li>Ability to work independently and as part of a team
</li><li>Strong written and verbal communication skills
</li><li>Ability to manage multiple tasks and adapt to changing priorities
</li></ul>Preferred Qualifications<ul><li>
Dental claims processing experience
</li><li>Dental office or dental assisting background
</li><li>Associate degree in Business Administration or a related field
</li><li>Dental or medical coding experience
</li><li>Healthcare or medical call center experience</li></ul><br>
<b>
Benefits</b><p><br>
MPF Federal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. We offer a competitive compensation package including a competitive salary, medical benefits, PTO, holiday pay and more.</p></div>

Dental Claims Resolution Specialist - TEMP

Horizon Blue Cross Blue Shield of New Jersey

<div><div>Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey&rsquo;s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.</div><div></div><div>
About the Role</div><div></div>
This position is responsible for initial claim pending resolution and claim adjustments. In addition this position is responsible for the initial examining, coding, and input of claims and referrals into the various processing systems.<div></div><div>
What You'll Do</div><ul><li>
Resolve edits on claims (pending resolution) and may require claim adjustments.</li><li>
Data entry of primary and secondary claims, as well as referrals into various processing systems.</li><li>
Return claims with unidentifiable information back to healthcare professional/subscriber with letter requesting additional information.</li><li>
Perform general clerical duties to ensure accurate disposition of claims/referrals that cannot be entered into the various processing systems.</li><li>
Perform other related duties as required by Management.</li></ul><div></div><div>
What You Bring</div><div></div><div>
Education/Experience:</div><ul><li>
High School Diploma or equivalent required</li><li>
Requires one (1) year of clerical business experience</li><li>
Medical Terminology/Billing/Coding experience preferred</li><li>
Experience in a Production and Quality driven work environment preferred</li></ul><div><br>
Additional licensing, certifications, registrations:</div><ul><li>
N/A</li></ul><div><br>
Knowledge:</div><ul><li>
Must be proficient with the use of personal computers and supporting software in a Windows based environment, including MS Office products.</li><li>
Should be knowledgeable in the use of intranet and internet applications; including ability to navigate.</li><li>
Strong typing, data entry and keyboarding necessary.</li><li>
Must be proficient using a calculator for simple math calculations.</li></ul><div><br>
Skills and Abilities:</div><ul><li>
Must be detail oriented with good organizational and data processing skills.</li><li>
Proven ability to follow detailed instructions is essential.</li><li>
Must demonstrate ability to learn quickly and apply learning to new situations.</li><li>
Must exhibit flexibility to change as appropriate.</li></ul><div><br>
Travel (If Applicable):</div><ul><li>
N/A</li></ul><div></div><div>
Why Horizon?</div><div></div><div>
At Horizon, you&rsquo;ll do meaningful work that directly improves lives&mdash;while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we&rsquo;d love to hear from you!</div><div></div><div>
Salary Range:</div>
$41,579 - $55,321<div></div><div>
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:</div><ul><li><div>
Comprehensive health benefits (Medical/Dental/Vision)</div></li><li><div>
Retirement Plans</div></li><li><div>
Generous PTO</div></li><li><div>
Incentive Plans</div></li><li><div>
Wellness Programs</div></li><li><div>
Paid Volunteer Time Off</div></li><li><div>
Tuition Reimbursement</div></li></ul><div></div><div>
Disclaimer:</div><div>
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.</div></div>

Claim/Pend Specialist

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