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

• One 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

Pay & Benefits

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: $14.97 - $28.12 Exact compensation may vary based on skills, experience, and location.

Luminare Health offers a robust total rewards package for associates, including:

• 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