Sr Claims Analyst
Health Care Service Corporation · Remote · remote · Posted 48d ago
Undisclosed3–8 yrsfulltimeSourced from
About a minute. You'll make an account on the way through.
About this role
At Luminare Health, our people are what set us apart. Their expertise, dedication, and passion for service excellence are the foundation of our success.
Were committed to helping our employees grow through thoughtful development opportunities, meaningful work, and a culture that values collaboration and continuous improvement. When you join Luminare Health, you join a purpose-driven team focused on making healthcare simpler, better, and more affordable.
In addition to these tasks, the Senior Claims Analyst is responsible for all of the same tasks as a Claim Analyst including the accurate adjudication and processing of medical, dental, vision, or other related claims, including related correspondence and/or electronic inquiries for assigned groups. All claims and inquiries are handled according to the established plan documents, claim processing guidelines, and established total turnaround times. Also advise team members regarding claim processing procedures.
Life Disability - Sr Claims Analyst
Secure and analyze claim information to make life and disability benefit determinations in accordance with policy provisions and appropriate state and federal laws; achieving results by effective use of all appropriate resources. Calculate benefit payments and communicate claim decisions on new and continuing claims. Provide responsive and caring customer service. All tasks completed under general supervision of management.
Required Job Qualifications:
- High School diploma or GED equivalent
- 3 years prior medical claim processing experience
- Ability to work in a fast-paced, customer centric production driven environment
- Excellent verbal and written communication skills
- Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff
- Demonstrated critical thinking, to carry out instructions furnished in oral, written or diagram form
- Flexible; open to continued process improvements
- Self-directed individual who works well with minimal supervision
- Good leadership, organizational and interpersonal skills
- Ability to effectively handle with complex situations and reach resolution
- Ability to analyze and interpret documents and Summary Plan Descriptions (SPDs)
- Ability to adapt to various system platforms, and to effectively use MS Excel/Word
Preferred Job Qualifications:
- Health Insurance/Third Party Administrator Experience
Preferred:
- Four-year college degree in medical and/or business field a plus.
- Understanding of medical terminology
Are you being referred to one of our roles If so, ask your connection at HCSC about our Employee Referral process!
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Pay Transparency Statement:
At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates .
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
Min to Max Range:
$18.07 - $33.92 Exact compensation may vary based on skills, experience, and location.
Disclaimer: This job posting and Location has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.
Sourced from naukri
Skills
Customer ServiceCustomer Centricemployee referralMedical TerminologyDentalAdjudicationHealthcareCommunication SkillsService Excellenceexcel