Hra Sr Claims Analyst (Remote)

Summary Of Overall Purpose

State the general nature and purpose of the job and provide a brief description of the duties and responsibilities (3-5 Statements). This information will be used to create the job posting but it is not the job posting. It may be easier to write the general summary after completing other sections of the job description.

Administration of HRA product line in accordance with the policy provisions and/or appropriate state and federal laws. Thoroughly investigate all claims by implementing action items, ordering and objectively evaluating data and thoroughly utilizing resources appropriately. Build benefit packages for plans according to client specifications with a focus on accuracy and timeliness of work.

Key Accountabilities

Percentage of Time

50%

• Run and handle claim reports in various systems as requested by internal and external sources.
• Identify and assist in one touch resolution of claim & eligibility questions and miscellaneous issues received through various email accounts or Customer Service queues.
• Administer HRA claim payments in accordance with policy provisions.

10%

• Build HRA benefit plans in the Defined Care Platform

10%

• Handle customer service inquiries from customers, both internally and externally.

10%

• Participate in project teams aimed at development of or enhancements to consumer driven healthcare products.

10%

• Act as consumer directed healthcare liaison to all divisions as well as to vendors that partner with them.

10%

• Other duties as needed/assigned.

EDUCATION And EXPERIENCE

Minimum Requirements

Preferred

• Flexible and adaptive to change
• Ability to work independently and prioritize workload
• Strong organizational skills and the ability to meet deadlines
• 2-4 year College Degree in an accredited institution of higher learning. Studies in the medical field are preferred.
• 3-5 years claims paying experience
• Ability to accept feedback and be a positive role model
• Minimum 3-5 years of claims knowledge or experience (including but not limited to customer service, billing, subrogation, or working in a medical office)
• Research, analytical and problem-solving skills
• Strong letter writing skills
• High School Diploma
• Working knowledge of Operating System(s)used by the Claims Area
• Ability to collaborate professionally as a team member
• Has the ability to communicate effectively with others, both verbally and in writing.
• Strong customer service skills

Required Skills

Required Experience