Luminare Health ยท 1 day ago
Claims Analyst
Luminare Health is a purpose-driven company that focuses on empowering employees through curated development plans. The Claims Analyst is responsible for the accurate adjudication and processing of various claims, ensuring compliance with established guidelines and turnaround times.
Health CareInsuranceTelehealth
Responsibilities
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
Qualification
Required
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
Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form
Flexible; open to continued process improvement
Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word
Preferred
1 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
Benefits
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
Other incentives