Claims Analyst Jobs

We are seeking a dedicated and detail-oriented individual to join our team as a Claims Analyst The ideal candidate will have a strong background in claims processing and data entry, coupled with excellent attention to detail.

Responsibilities:

• Contribute subject area expertise to determine processing guidelines and assess compliance
• Verify data and processing requirements, making necessary corrections
• Utilize attention to detail and critical reasoning skills
• Process claims, correspondence, and escalations to achieve team goals and priorities
• Perform reissue processing tasks without phone communication
• Meet hourly and daily production and quality goals
• Follow written process and procedures consistently, without deviation
• Use proprietary software tools for accessing, reviewing, and entering claim decisions
• Perform data entry and verification tasks
• Ensure adherence to departmental standards using documented team processes
• Verify name changes on checks accurately to ensure correct customer information
• Draw logical conclusions based on guidance and consult leadership when necessary
• Work independently without constant oversight (WFH)
• Complete other assigned projects
• Exceed departmental expectations for accuracy and productivity
• Draft claimant communications based on provided guidance
• Ensure satisfaction of internal and external clients regarding claim handling and Service Level Agreements

Qualifications and Experience:

• Professional degree or equivalent experience

• Experience in claims processing, data entry, and call center with escalation exposure

• Excellent attention to detail

• Proficiency in using multiple applications/software concurrently (at least six)

• Strong written and verbal communication skills

• Sharp critical thinking and judgment abilities

• Ability to sit at a computer workstation for extended periods

• Effective multitasking and adaptability to change

• Working knowledge of computers, including familiarity with the start menu, folder creation, right-clicking, navigating computer settings, and setting up a computer at home without issues.

Work from Home Requirements:

• Dedicated workspace ensuring minimal noise and external disturbances, and safeguarding confidential information

• Reliable WIFI connection (no hotspots)