Claims Analyst

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

📋 Description

• Precisely adjudicate and process medical, dental, vision, and other related claims for designated groups

• Manage related correspondence and electronic inquiries

• Process all claims and inquiries in accordance with established plan documents and claims processing guidelines

• Achieve established total turnaround times

• Review claims and carry out investigations

• Make decisions independently and in the absence of specific instructions

• Prioritize workload, manage, and follow up on multiple tasks

• Adapt to evolving processes and dynamic work settings

• Collaborate with team members, employees/members, providers, and clients

⛳️ Requirements

• High School diploma or GED equivalent

• Capability to thrive in a fast-paced, customer-focused, and production-oriented environment

• Proficient verbal and written communication skills

• Ability to work collaboratively with team members, employees/members, providers, and clients

• Capacity to apply common sense understanding to execute oral, written, or diagram-form instructions

• Open-minded and flexible towards continuous process improvement

• Ability to learn new or proprietary systems and adapt to various system platforms

• Proficient in MS Excel and Word

• Understanding of claims examination processes

• Strong investigative, analytical, and organizational abilities

• Keen attention to detail

• Strong mathematical and decision-making capabilities

• Ability to work effectively in a deadline-driven, fast-paced environment

• Self-motivated with a high capacity for learning

• Excellent verbal and written communication skills with a dedication to assisting others

• Strong time management skills to prioritize workload and manage multiple tasks

• Ability to make decisions with minimal oversight

• Capability to adjust to change and pivot in a dynamic environment

• Strong commitment to teamwork and collaborative work

• Effective use of personal computers and related software

• Proficient in Word, Excel, and Outlook

🏝️ Benefits

• Curated development plans

• Health and wellness benefits

• 401(k) savings plan

• Pension plan

• Minimum of 15 days’ paid time off

• Paid parental leave

• Disability insurance

• Supplemental life insurance

• Employee assistance program

• Paid holidays

• Tuition reimbursement

• Other incentives

• Annual incentive bonus plan subject to plan terms and conditions