Claims Adjuster Blue Card-3 OPEIU

Location: Remote within specified counties in New York State: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, or Wyoming

Company

hirify.global provides healthcare insurance claims administration and related customer services.

What you will do

• Review and adjust Blue Card claims according to contracts, provider agreements, and corporate procedures.
• Process online transactions and adjustments using the corporate claims administration system.
• Identify potential fraud cases and refer them to the Special Investigations Department.
• Resolve customer issues, answer written and verbal inquiries, and initiate related correspondence or telephone contact.
• Document process improvement opportunities and provide recommendations on departmental procedures and desk levels.
• Maintain accurate production records and protect confidential customer information in accordance with HIPAA requirements.

Requirements

• Healthcare or insurance-related experience, claims processing experience, and knowledge of medical terminology.
• High school diploma or GED.
• Residence in one of the specified New York State counties is required under the collective bargaining agreement.
• Proficiency in English communication, including spelling, punctuation, and grammar.
• Successful completion of required training and testing, including basic computer literacy, typing at 30 WPM, and a job content test.
• Ability to multitask in a fast-paced environment, manage time effectively, solve problems, and use basic office equipment.

Culture & Benefits

• Office- or remote-based position with no regular physical work site requirement.
• Travel requirement of 0%–25%.
• Union-represented position covered by the Local 153 OPEIU collective bargaining agreement.
• Work requires adherence to HIPAA, data security policies, the Code of Business Conduct, and applicable laws.
• Starting hourly pay for new employees is established by the collective bargaining agreement and is non-negotiable.