Claims Analyst - LHB

Job Summary

The Claims Analyst is responsible for 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.

Required Job Qualifications

• High School diploma or GED equivalent
• Ability to work in a fast-paced, customer centric and production driven environment
• Effective verbal and written communication skills
• Ability to work effectively with team members, employees/members, providers, and clients
• Able to use common sense understanding to carry out instructions furnished in oral, written or diagram form
• Flexible; open to continued process improvement
• Able to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word

Preferred Job Qualifications

• 1 year Health Insurance experience
• Self-Funded Insurance/Benefits and/or TPA experience
• Knowledge of medical procedure and diagnosis coding
• Knowledge of medical terminology
• Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools

LIFE & DISABILITY - CLAIMS ANALYST Required Job Qualifications

• An understanding of claims examining; solid investigation, analytical and organizational skills, and attention to detail
• Solid math and decision-making skills
• Ability to work in a deadline driven, fast-paced environment
• Self-motivated with high learning agility
• Excellent verbal and written communication skills with a passion for helping others
• Strong time management skills to prioritize workload, manage and follow-up on numerous tasks
• Able to make decisions in the absence of specific directions with minimal supervision
• Ability to effectively cope with change and shift gears accordingly in a dynamic environment
• A strong commitment to teamwork and ability to work in a collaborative environment
• Effective in the use of personal computers and related software
• Proficiency in working with Word, Excel and Outlook

Preferred Job Qualifications

• Four-year college degree in medical and/or business field
• Life and/or Disability claim knowledge
• Knowledge of medical terminology
• Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools
• Proficiency in working with Microsoft Access

EEO Statement

We are an Equal Opportunity 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 CareAllies, 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, a minimum of 15 days’ of 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 full-time employees. The salary 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: $14.97 - $28.12 Exact compensation may vary based on skills, experience, and location.