SoTalent · 17 hours ago
Claims Analyst
San Antonio, TX
Full-time
Onsite
Senior Level
$19/hr - $31/hr
5+ years expSoTalent is a leading healthcare organization seeking a Claims Analyst to provide advanced support in resolving complex claim issues and ensuring accurate payment processes. The role involves analyzing challenging claim matters, serving as a consultant to claims staff, and collaborating with configuration teams to ensure accurate auto-adjudication.
Staffing & Recruiting
Hiring Manager
Raja Panneerselvam
Responsibilities
Analyze and resolve challenging claim matters related to payments, eligibility, insurance coordination, transplants, and system discrepancies beyond the scope of standard examiners
Serve as a consultant to claims staff, offering guidance on complex claim resolution
Collaborate with configuration teams to test contracts and reporting systems to ensure accurate auto‑adjudication
Uphold company standards, policies, and compliance requirements while fostering strong relationships across departments
Operate independently with limited supervision while promoting teamwork and efficiency
Qualification
Required
High school diploma or GED required
Minimum of 5 years of experience in HMO/PPO claims processing
Strong knowledge of benefit programs including Medicaid, HMO, PPO, and ASO
Preferred
Familiarity with Amisys claims processing systems
Company
SoTalent
At SoTechTalent, we specialise in connecting forward-thinking tech companies with world-class talent.
2-10 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase