Claims Analyst

This is a fully remote position, open to applicants in Texas.

📋 Description

• Utilize acquired expertise to provide exceptional, consultative interactions with customers.

• Represent members by collaborating with carriers, providers, and plan documentation.

• Address post-service coverage inquiries and issues promptly and accurately.

• Examine medical, dental, vision, and pharmacy claims for precision and appropriate benefit coverage.

• Work with providers and carriers to rectify billing discrepancies, coding mistakes, and denied claims.

• Assist in claim resubmissions as required.

• Prepare, submit, and thoroughly pursue appeals processes when necessary.

• Collaborate with clients on specific care and billing circumstances that necessitate special attention.

• Liaise with providers to establish payment plan and discount options.

• Navigate through internal tools and applications efficiently.

• Engage in external communications via phone and email outreach.

• Manage cases through resolution at the employee level.

⛳️ Requirements

• Bachelor's Degree, Associate's Degree with 2 years of billing/insurance experience, or 3 years of experience in a healthcare billing/insurance-related position.

• Capacity to work efficiently in a remote team setting.

• Strong problem-solving, reasoning, and analytical abilities.

• Excellent verbal and written communication skills.

• Capability to explain complex billing concepts to non-expert members.

• Strong eagerness and ability to learn continuously in a dynamic environment.

• Proficient in organizing work tasks to meet deadlines effectively.

• Commitment to delivering the highest level of client satisfaction.

• Ability to receive and promptly implement constructive feedback.

• Skill in building effective rapport with clients based on empathy and trust.

• Successful completion of a background check, where applicable.

• Must possess work authorization in the Employing Country without any current or future visa sponsorship required.

• Preferred: knowledge and expertise in Medicare, FSA, HRA, HSA, and the claims adjudication process.

🏝️ Benefits

• Health, dental, and vision coverage starting from Day One.

• Wellbeing programs.

• Retirement plans with contribution matching.

• Generous time off.

• Parental leave.

• Continuing education opportunities.

• Career growth potential.

• Comprehensive benefits package effective from the first day of employment.

• Life insurance.

• 401k plan with corporate match.

• Paid Time Off.

• Ongoing training, coaching, and development.

• Flexible working arrangements whenever feasible.

• Reasonable accommodations for disabilities and sincerely held religious beliefs.