Claims Analyst - Virtual (US) / R-38022 / Remote

We need to output HTML fragment with sections: headings

for sections like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. Must not repeat job title as heading. Must not include Job ID etc. Remove boilerplate, navigation, legal, EEO, equal-opportunity, scam-warning, duplicated lines, application instructions. Must preserve all substantive info. We need to parse the posting. Let's extract sections: - About the role / Our Story? The posting starts with "Our Story At Alight, we believe..." then "We are now hiring ambitious, motivated Claim Analysts..." So we can have an "About the role" section describing role purpose. - Responsibilities: The bullet list under "As a Claims Analyst, You Can Expect The Following" includes training, primary responsibility, activities list. - Requirements / Qualifications: There's "Required Qualifications" and "Preferred Qualifications". Could combine into Requirements/Qualifications. - Skills: Might be part of qualifications. - Benefits: There's "Our Benefits" earlier and "We Offer You A competitive total rewards package..." includes health, dental, vision, life insurance, 401k match, Paid Time Off, Career Development & Growth, training, etc. Also "Flexible Working", "Great Place to Work". So we can have Benefits section. - Pay: Not mentioned explicitly. No salary. So we should NOT include Pay section. - Schedule: Not mentioned explicitly. No schedule details. So not include. We must not create sections with placeholder text. We need to use

for each section heading. Use

• for any list of duties/requirements/benefits. Use

  for prose

  . We must not repeat job title as heading. So no heading "Claim Analyst". Use generic headings. We must not include Job ID etc. We must remove boilerplate: "Our Story At Alight..." maybe keep as About the role? The "Our Story" is company description; could be part of About the role or maybe separate "About Alight". But headings allowed: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We can use About the role to include company overview and role description. We need to preserve all substantive info. Let's extract substantive paragraphs. Company description: "Our Story At Alight, we believe a company's success starts with its people. Alight embraces values that come directly from our people - purposeful, human, united and growth-minded - reflecting our inclusive culture and promise that our clients expect. We are passionate about connecting purpose with impact. Alight empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management." Then "Our Benefits With a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and vision coverages starting Day One. Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities - all within a thriving global organization." Then "Flexible Working So that you can be your best at work and home, we consider flexible working arrangements wherever possible. Alight has been a leader in the flexible workspace and "Top 100 Company for Remote Jobs" 6 years in a row." Then "Great Place to Work Thanks to the work of every colleague, Alight has received multiple awards of recognition including "Great Place to Work" for the past 7 years and Fortune's "Best Companies to Work For." To learn more about our company culture and awards Click Here." Then "We invite you to join our team! Learn more at careers.alight.com." Then role intro: "We are now hiring ambitious, motivated Claim Analysts to work in our team focused, premier healthcare navigation business. In this role, you will be leveraging acquired knowledge to deliver high quality customer interactions that are consultative and lead to better healthcare outcomes. Through this role, you will have the opportunity to positively impact the lives of employee customers and their families, while driving increased benefit satisfaction and reducing healthcare spend for their employers." Then "We Offer You A competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization: A full Benefits Package, starting on your first day of employment Health, Dental, Vision, Life Insurance and more. A 401k plan that includes a corporate match. Paid Time Off Career Development & Growth We provide ongoing training, coaching and development. We reward continuous improvement and encourage you to own your own development. Take advantage of some of the best training and tools in the world to learn more about multiple areas of Human Resources! Alight provides a collaborative environment that embodies and holds the following stated values close to heart: Champion people, Grow with purpose, and Be Alight." Then "As a Claims Analyst, You Can Expect The Following When you start, you will receive extensive health care training to ensure you are equipped to consult members on billing related issues Your Primary Responsibility Is To Be An Advocate For Members By Working On Their Behalf With Carriers, Providers, And Plan Related Documentation To Resolve Post-service Coverage Questions And/or Issues In An Accurate And Timely Manner. Activities Include, But Are Not Limited To The Following Assist in reviewing medical, dental, vision, and pharmacy related claims for accuracy to ensure members are receiving the proper benefit coverage according to plan stipulations Coordinate with providers and carriers to solve billing discrepancies, coding rrors, and denied claims; assist with claim resubmission, as necessary Draft, submit, and exhaust appeals processes, as necessary Partner directly with client to bring awareness to unique care/billing situations that may require special review Coordinate with providers to determine payment plan and discount options This work involves leveraging developed methodologies, navigating internal tools, and applications, as well as making external phone calls, and partnering with carriers and providers (via email and phone outreach) to resolve member needs. The scope of work is dedicated at the employee level and you will be responsible for working cases through resolution." Then "Required Qualifications Bachelor's Degree, Associate's Degree with 2 years billing/insurance experience, or 3 years' experience in a healthcare billing/insurance related role Ability to work effectively in a remote team environment Strong problem solving, reasoning, and analytical skills Exceptional verbal and written communication skills - ability to articulate complex billing concepts for members that are not experts Strong ability and desire to learn continually in a changing environment Ability to efficiently organize work activities to meet deadlines Passion to provide the highest level of client satisfaction Ability to receive and immediately apply constructive feedback Ability to develop effective rapport with clients based on empathy and trust" Then "Preferred Qualifications Expertise and current knowledge of Medicare, Health accounts (FSA, HRA, HSA), and claims adjudication process" Then "Application and Interview By applying for a position with Alight, you understand that, should you be made an offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight's employment policies. Background checks may include some or all the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal check, search against global sanctions and government watch lists, credit check, and/or drug test. You will be notified during the hiring process which checks are required by the position. Alight requires all virtual interviews to be conducted on video. Please be aware that Alight is a camera-on culture and may require occasional travel to one of our physical office locations." Then "Our commitment to Inclusion We celebrate differences and believe in fostering an environment where everyone feels valued, respected, and supported. We know that diverse teams are stronger, more innovative, and more successful. At Alight, we welcome and embrace all individuals, regardless of their background, and are dedicated to creating a culture that enables every employee to thrive. Join us in building a brighter, more inclusive future. As part of this commitment, Alight will ensure that persons with disabilities are provided reasonable accommodations for the hiring process.If reasonable accommodation is needed, please contact alightcareers@alight.com." Then "Equal Opportunity Policy Statement Alight is an Equal Employment Opportunity employer an" (cut off). This is boilerplate EEO; we should remove. Also remove navigation/legal/EEO etc. Also remove "Application and Interview" maybe considered application instructions? It includes background check info, which is substantive? Might be considered part of hiring process but could be considered boilerplate. The instruction says remove application instructions. The background check info is part of application process; likely considered application instructions. Safer to remove that section. Also remove "Our commitment to Inclusion" maybe considered EEO? It's about inclusion; could be considered part of company culture, but might be considered EEO boilerplate. However it's substantive about inclusion and accommodations. Might keep as part of Benefits or About the role? The instruction says remove EEO/equal-opportunity/scam-warning boilerplate. The inclusion statement is about diversity and accommodations; could be considered EEO. Safer to remove. Thus we keep: company story, benefits, flexible working, great place to work, role intro, responsibilities, required qualifications, preferred qualifications, maybe values. We need to structure into sections with headings. Possible sections: - About the role (or About Alight) containing company story and role intro. - Responsibilities (activities list) - Requirements (maybe combine Required and Preferred Qualifications) - Benefits (including health, dental, vision, life insurance, 401k match, PTO, career development, flexible working, great place to work) - Skills? Could be part of requirements. We should not create thin sections. Let's make:

  About the role

  with paragraphs covering company story, mission, values, and role purpose.

  Responsibilities

  with
  • list of activities.

    Requirements

    with
    • for required qualifications and maybe preferred qualifications as separate list? Could have two lists: Required and Preferred. But we need to avoid too many sections. Could embed both under Requirements with headings inside? But only allowed headings are those specific; we cannot add extra headings like "Required Qualifications". Could use

      to separate. But we need to use

      • for any list. So we can have two
        under Requirements: one for Required, one for Preferred, each preceded by a

        describing. Alternatively we could have separate sections: Requirements and Qualifications. But we have both headings allowed: Requirements and Qualifications. Could use Requirements for required qualifications, Qualifications for preferred qualifications. That seems appropriate. Thus:

        Requirements

        • ... required qualifications items.

          Qualifications

          • ... preferred qualifications. Skills maybe not needed. Benefits section: include health, dental, vision, life insurance, 401k match, PTO, parental leave, continuing education, career growth, flexible working, great place to work awards. We need to ensure we don't include filler like "commensurate with experience". Not present. Now we need to extract exact text for list items. Let's extract responsibilities list: From "Activities Include, But Are Not Limited To The Following" then list: - Assist in reviewing medical, dental, vision, and pharmacy related claims for accuracy to ensure members are receiving the proper benefit coverage according to plan stipulations - Coordinate with providers and carriers to solve billing discrepancies, coding errors, and denied claims; assist with claim resubmission, as necessary - Draft, submit, and exhaust appeals processes, as necessary - Partner directly with client to bring awareness to unique care/billing situations that may require special review - Coordinate with providers to determine payment plan and discount options Also earlier: "Your Primary Responsibility Is To Be An Advocate For Members By Working On Their Behalf With Carriers, Providers, And Plan Related Documentation To Resolve Post-service Coverage Questions And/or Issues In An Accurate And Timely Manner." That's a responsibility statement; could be included as a

            before list. Also "When you start, you