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Analyst Claims Jobs

Claims Analyst - Remote ($19.65 - $34.19 / Hour)
By Talentify.io At United States
Investigate, analyze, and respond to complaints from various sources, including Consumer Protection Agencies, Regulatory Agencies, Attorneys, and Upper Management
1-2 years of previous customer service experience
Bachelor's Degree or equivalent work experience
Basic mechanical, technical, and contract knowledge
Previous leadership experience desired but not required
Comprehensive benefits package including medical, dental, vision, 401k, PTO/paid sick leave, and employee stock purchase plan
Claims Administrator Jobs
By County Materials Corporation At Marathon City, WI, United States
Any other tasks as assigned by management.
Familiar with standard risk management and insurance concepts, practices, procedures, laws, and regulations
Digital app capabilities for payroll, benefits, and communication
Maintain contact with adjusters, agents, employees, third party insurance companies, medical clinics, and nurse case managers during the claim process.
Communicate policies and procedures for claims to managers, supervisors, and other team members.
Administer the company’s drug testing program; communicate the company’s drug testing policy to managers, supervisors, and other employees.
Remote Claims Analyst ($18.00 / Hour)
By Talentify.io At United States
A minimum of 1 year of prior claims experience
A professional degree or equivalent experience
Strong communication skills, both written and verbal
Sharp critical thinking skills with sound judgment
Perform data entry and verification
Verify data and processing requirements and make corrections as necessary
Director, Claims Operations Jobs
By HealthEZ At Greater Minneapolis-St. Paul Area, United States
Experience with vendor data connectivity management
Experience with stop loss management, flexible spending, and HRA/HSA administration preferred
Maintain up-to-date industry knowledge related to claims processing, including compliance requirements and claim integrity/fraud components, and other pertinent industry standards.
5 years’ experience with leadership responsibilities in administration of self-funded TPA healthcare plans
Experience with Virtual Benefits Administrator (VBA)
Design and implement data validation controls for the enrollment and claims processing application, Virtual Benefits Administrator (VBA).
Claims Administrator Jobs
By VSP Vision Care At California, United States

Typically Has The Following Skills Or Abilities

Claims Technician Jobs
By BlueCross BlueShield of South Carolina At Florence, SC, United States
No previous work experience required
Strong organizational and analytical skills
Knowledgeable in word processing and spreadsheet applications
Receive, open, sort, and distribute incoming departmental mail or work requests
Check workflow documents to ensure required information is available
Request any missing documentation as needed
Analyst, Claims Finance Jobs
By Branch At United States
Bachelor's degree in finance, accounting, or a related field. Advanced degrees or certifications are a plus.
Support the Claims Finance team in monthly and quarterly reporting of the claims organization's performance, including efficiency metrics and financial results.
Collaborate with finance, accounting, and data analytics teams to ensure accurate and consistent financial reporting related to claims operations.
Stay informed about industry best practices, regulatory changes, and advancements in claims finance methodologies to enhance monthly and quarterly reporting processes.
Collaborate with cross-functional teams, including claims, finance, actuarial, and operations, to drive collaboration and achieve shared reporting goals.
Strong analytical skills and proficiency in financial analysis tools, such as Excel and data visualization software, for monthly and quarterly reporting.
Data Analyst - Claims
By Trillium Health Resources At Greenville, NC, United States
Prefer experience in the areas of data analysis, data management, statistics, reporting, and use of databases.
Your resume must provide your level of education and detailed work experience, including:
Must reside in NC to be considered for remote status
Maintain a schedule of reporting and distribute reports to departmental staff and internal/external committees.
Reconcile data flows between processing systems; identify and report any discrepancies.
Ensure claims have processed to the correct funding source.
Medicaid Claims Analyst (Remote)
By Better Health Group At Tampa, FL, United States
Work collaboratively with the internal Field Operations team to establish (remotely from the central office)
High School Diploma / GED (or higher) or equivalent work experience.
Medical Assistant, CMA, CNA or MEDIC/prior Combat Medic experience a plus.
Experienced in Excel, Google Sheets
Demonstrated STRONG organizational skills and attention to detail
Demonstrated excellent written and verbal skills
Claims Analyst Jobs
By STO Building Group At New York, United States
Strong plus if possessing a claims management background.
Finance and/or claims experience a plus but not necessary.
Knowledge of Microsoft Word and Excel.
Knowledge of Origami and other RMIS systems.
Strong analytical, communication and decision making skills.
Service focused and communication skills.
Death Claims Analyst (Remote Possible)
By Equitable At Charlotte, NC, United States
Determines appropriate beneficiary and identifies and obtains requirements needed to process the claim within state and federal guidelines.
Handles escalated requests and is considered a recognized technical resource whose knowledge encompasses a broad range of products and procedures.
2+ years of experience in financial services industry or customer service
Knowledge of the Death Claims process
Sound analytical, problem solving and decision making skills
Able to research and resolve standard issues.
Claims Research Analyst Jobs
By BlueCross BlueShield of South Carolina At South Carolina, United States
Good time management skills and adaptable to change.
3 years of experience processing claims in a healthcare environment.
2 years of experience with claims systems (can be concurrent).
In-depth knowledge of claims payment policies and refund policies.
Knowledge of related claims software systems.
Knowledge of medical terminology, CPT IV coding, ICD 9 diagnosis codes, or NCPDP coding as appropriate.
Claims Analyst Jobs
By Catalyst Solutions At United States
Nice to have: QNXT experience
Support day to day claims processing
Medicare, Medicaid, COB, and complex claims needed.
Will be high volume with high accuracy needed.
Claims Operations Analyst Jobs
By Munich Re At Greater Philadelphia, United States
Excellent organizational, multi-tasking and time management skills.
Input payment data and issue timely payments to insureds, claimants, vendors and associated parties.
Ensure that checks, ACH payments, and wire transfers are efficiently processed and recorded.
Reconcile and process financial transactions related to account replenishments and reimbursements.
Request, process and import third-party data submissions while identifying any issues/inconsistencies.
Prioritize daily workload to ensure that all tasks are completed within their deadlines.
Claims Business Analyst-Remote Jobs
By Sunshine State Health Plan At , , Fl

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll ...

Claims Analyst I Jobs
By Towne Park At United States
Six to twelve months related experience and/or training; or equivalent combination of education and experience.
High school diploma or general education degree (GED)
Ability to manage several projects simultaneously while working under pressure to meet deadlines.
The individual identifies and resolves problems in a timely manner and gathers and analyzes information skillfully.
Excellent written communications skills to provide any necessary correspondence with internal and external customers.
Reasonable accommodations may be made to enable individuals with disabilities to perform all functions.
Analyst, Claims-Pet (Veterinary Technician) Remote
By Nationwide At , Columbus, 43215, Oh
Identifies and advises management of questionable claims and questionable risks.
Other criteria, including leadership skills, competencies and experiences may take precedence.
May perform other responsibilities as assigned.
Accurately processes claims based on established criteria, provider contract plan and employer group provisions.
Requests, reviews and evaluates requested medical records or treatment notes for determination of resolving claims.
Ensures proper documentation in compliance with company policies and practices. Records the final disposition of claims, including denial and/or issuing payment.
Claims Analyst I Jobs
By Cook Children's Health Care System At , Fort Worth, 76116, Tx
(3) years of experience in claim service area within Managed Care Organizations, Insurance, or related fields is required by the incumbent.
Excellent Customer Service Skills with ability to explain complicated claim issues to providers; ability to resolve conflict.
Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer
Claims Analyst - Remote
By Trustmark At United States
1 year of health insurance experience or medical terminology knowledge is a plus
Determine benefit coverage based on clinical edits, plan documents/booklets, benefit reference documents, Claim Reference Manuals and claims-related memoranda, and reports.
Effective verbal and written communication skills
Review, analyze and interpret claim forms and related documents.
Appropriately investigate, pend and refer claims based on claim procedures and guidelines.
Accurately handle correspondence, claims, and referrals in the established timeframes and/or performance guarantees.
Billing Analyst(Claims) Jobs
By VDart At United States
Skills: Billing , Excel abilities, Auditing Skills and Verbal/Writing etiquette
Good Excel skills are needed with ability
Schedule: Monday-Friday 8:00 – 5:00 EST
audits and handling research items for Consultants.
Audits of policies and cases
3. Responding to emails from customers

Are you looking for an exciting opportunity to use your analytical skills to make a difference? We are looking for an Analyst to join our team and help us uncover insights that will shape the future of our business. You will be responsible for analyzing data, developing models, and providing recommendations to drive business decisions. If you are passionate about data and eager to make an impact, this is the job for you!

Overview An Analyst Claims is a professional who is responsible for analyzing and processing insurance claims. They are responsible for ensuring that claims are handled in a timely and accurate manner, and that all relevant information is collected and documented. Detailed Job Description An Analyst Claims is responsible for reviewing and processing insurance claims. This includes gathering and verifying information from claimants, reviewing and analyzing claim documents, and determining the validity of the claim. The Analyst Claims must also ensure that all relevant information is collected and documented, and that the claim is handled in a timely and accurate manner. Job Skills Required
• Knowledge of insurance policies and procedures
• Excellent communication and interpersonal skills
• Ability to analyze and interpret data
• Ability to work independently and as part of a team
• Proficiency in Microsoft Office Suite
• Ability to multitask and prioritize tasks
• Strong problem-solving skills
• Attention to detail
Job Qualifications
• Bachelor’s degree in a related field
• Previous experience in insurance claims or related field
• Knowledge of insurance policies and procedures
• Ability to analyze and interpret data
• Proficiency in Microsoft Office Suite
Job Knowledge An Analyst Claims must have a thorough understanding of insurance policies and procedures, as well as the ability to analyze and interpret data. They must also be familiar with Microsoft Office Suite and have strong problem-solving skills. Job Experience Previous experience in insurance claims or a related field is preferred for an Analyst Claims position. Job Responsibilities
• Review and process insurance claims
• Gather and verify information from claimants
• Review and analyze claim documents
• Determine the validity of the claim
• Ensure that all relevant information is collected and documented
• Handle claims in a timely and accurate manner
• Maintain accurate records of claims
• Communicate with claimants and other stakeholders
• Resolve any disputes or discrepancies
• Monitor and report on claims trends and patterns
• Assist with other tasks as needed