Independence Blue Cross · 12 hours ago
Claims Specialist
Philadelphia, PA
Full-time
Onsite
Entry Level
1+ years expIndependence Blue Cross is seeking a Claims Specialist to handle claim issues across various lines of business. The role involves researching inquiries, ensuring accurate claim processing, and meeting departmental standards for quality and production.
Health CareHealth InsuranceInsuranceMedical
Responsibilities
Responsible for accurate and timely handling of claim issues for all lines of business, including bi-directional sharing, FEP, Local and Commercial PA and AHNJ, BlueCard and Government market
Research inquiries received from all areas, inclusive of internal and external sources (e.g. other plans, providers, legal, Sales); as required, perform member or provider payable claim payment adjustments when appropriate following the correct processing guidelines
Meet departmental quality and production requirements
Respond professionally to internal and external inquiries, as appropriate, while maintaining corporate and departmental standards
Research claims that are paid incorrectly; recover overpaid and underpaid claim dollars from multiple sources and ensure all necessary transactional steps are taken to accurately process claim adjustments
Provide response to general questions within expected departmental standards of initial inquiry; provide daily feedback, status updates and targeted resolution dates for more complex issues
Complete special projects and participate in work groups as assigned
Perform other duties as necessary
Qualification
Required
High School graduate or equivalent work experience
1 – 3 years proven work experience in a production environment
Demonstrated math and comprehension skills required
Good interpersonal skills for handling internal and external customers
Well-developed listening, verbal and written communication skills
Proficiency with Microsoft Office, specifically Excel and Word is required
Ability to research and investigate information using multiple sources, operating systems and documented guidelines
Must have strong organizational skills and problem solving ability
Must be detail-oriented
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app
Company
Independence Blue Cross
The leading health insurer in southeastern Pennsylvania. It is a sub-organization of Independence Blue Cross.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Alexandra Jorgensen
Senior Vice President Human Resources
Joe Geist
SVP & Market President, National
Recent News
Home Health Care News
2026-01-14
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