Claims Processor

Job Duties

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Blue Cross and Blue Shield of Minnesota

Position Title: Claims Processor

Location: Remote

Career Area: Customer Service/Operations

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

The Impact You Will Have

As a Claim Processor you will be responsible for accurately and efficiently reviewing, researching, and adjudicating health insurance claims including out-of-state and international cases. This role involves verifying benefit eligibility, analyzing claim history and records, applying pricing and edits, and ensuring all claims are processed with a strong focus on quality and timeliness.

What You'll Do

* Review, research, andadjudicateclaims accurately, following established processesandprocedures witha high levelofattention to detail. * Receive and prioritize daily or weekly workload reports, focusing on aging claims and time-sensitive items. * Differentiate and processvarious typesof claims, adapting to changing priorities and business needs.

Now Hiring - September 21, 2026 Start Date

Must reside in Minnesota to be eligible for this position.

Hiring approximately 15 Claims Processors

Paid training provided to prepare you for success in the role.

* Training start date: September 21, 2026 * Training schedule: Monday-Friday, 8:00 AM -4:30 PM CST * Training duration: Approximately 4-6 weeks * Schedule after training is flexible and could vary between 6:00 AM - 5:00 PM

100% remote, work-from-home position

* High-speed, land-based internet service is required * Internet connection must be hard-wired from your router to company-provided equipment

Pay range:$22.50-$23.50 per hour, based on experience.

How You'll Do It

* Exercise critical thinking and problem-solving skills to resolve claim issues independently, with support available when necessary. * Ensure thorough documentation of claim decisions and updatesin accordance withcompany standards * Collaborate with peers and internal technical specialists for guidance and documentation updates. * Communicate viawritten and/orphone whenrequiredto clarify claim details or obtainadditionalinformation. * Maintain compliance and accuracy by meeting established performance metrics during monthly audit reviews and incorporating feedback. Undergo monthly audit reviews and implement feedback to ensure accuracy, compliance, and adherence to performance standards.Subject to monthly audits with results measured against accuracy and compliance standards; incorporate feedback to drive ongoing improvement. * Develop andmaintainindividual development plans, including goals andobjectives;engage inmonthly check-ins andparticipatein mid-year and year-end performance reviews with supervisors. * Provide support during peak business periods and emergency situations, including natural disasters, byassistingwith critical operational needs. * Engage with Associate Resource Groups to foster networking and professional development opportunities. * Performs additional responsibilities consistent with the scope and level of the role, as assigned.

Required Skills & Experience

* 1+ years of related work experience * High school diploma (or equivalent)

Preferred Skills & Experience

* Ability to communicate clearly with varied internal contacts, actively listen to clarify needs, and ensure accurate and timely information exchange. * Ability to recognize patterns in recurring issues, gather relevant information, and collaborate with others to implement practical solutions. * Ability to organize and prioritize tasks across assignments, manage time effectively, and adjust to shifting workloads while maintaining accuracy. * Claims processing experience. * Knowledge of medical terminology and healthcare regulations. * Strong attention to detail and accuracy.

Role Designation

Remote

Teleworker

Role designation definition: Teleworking is working full time remote. Hybrid is a minimum of 2 days onsite. Onsite is full-time onsite.

Compensation and Benefits:

Pay Range: $21.50 - $24.59 - $29.51 Hourly

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

* Medical, dental, and vision insurance * Life insurance * 401k * Paid Time Off (PTO) * Volunteer Paid Time Off (VPTO) * And more

To discover more about what we have to offer, please review our benefits page(

Equal Employment Opportunity Statement

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: View email address on click.appcast.io.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

Physical Requirements(

Apply Here:

PI285898352

Minimum Education Required

See job description.

Minimum Experience Required

See job description.

Shift

First (Day)

Number of Openings

1

Public Transportation Accessible

Yes

Compensation

$21.50 - $29.51 / Hourly

Postal Code

55121

Job Type

Full Time

Place of Work

On-site

Requisition ID

39018

Job Benefits

Health Insurance