Apply on Employer Site

Health Care Service Corporation · 4 months ago

Sr Claims Analyst - LHB

United States

Full-time

Remote

Mid, Senior Level

$17.71/hr - $33.25/hr

3+ years exp

Luminare Health is a purpose-driven company that invests in the professional development of its employees. The Senior Claims Analyst is responsible for adjudicating and processing various types of claims while providing excellent customer service and support to the Claims Team and other internal departments.

Health InsuranceInsurance

Growth Opportunities

No H1B

Responsibilities

Secure and analyze claim information to make life and disability benefit determinations in accordance with policy provisions and appropriate state and federal laws; achieving results by effective use of all appropriate resources

Calculate benefit payments and communicate claim decisions on new and continuing claims

Provide responsive and caring customer service

Advise team members regarding claim processing procedures

Qualification

Medical claim processingCritical thinkingCustomer serviceMS ExcelDocument analysisSelf-directedVerbal communicationWritten communicationLeadership skillsOrganizational skillsInterpersonal skillsFlexibility

Required

High School diploma or GED equivalent

3 years prior medical claim processing experience

Ability to work in a fast-paced, customer centric & production driven environment

Excellent verbal and written communication skills

Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff

Demonstrated critical thinking, to carry out instructions furnished in oral, written or diagram form

Flexible; open to continued process improvements

Self-directed individual who works well with minimal supervision

Good leadership, organizational and interpersonal skills

Ability to effectively handle with complex situations and reach resolution

Ability to analyze and interpret documents and Summary Plan Descriptions (SPDs)

Ability to adapt to various system platforms, and to effectively use MS Excel/Word