Senior Claims Analyst
Remotedxb
Responsibilities
- Perform accurate adjudication and processing of medical, dental, vision, and other related claims
- Secure and analyze claim information to make life and disability benefit determinations
- Calculate benefit payments and communicate claim decisions on new and continuing claims
- Provide responsive and caring customer service to members and providers
- Advise team members regarding claim processing procedures
- Handle correspondence and electronic inquiries for assigned groups according to plan documents
Requirements
- High School diploma or GED equivalent
- 3 years of medical claim processing experience
- 3 years of life and/or disability claim administration experience
- Proficiency in MS Excel, Word, and Outlook
- Strong math and decision-making skills
- Ability to analyze and interpret Summary Plan Descriptions (SPDs)
Preferred Qualifications
- Health Insurance or Third Party Administrator experience
- Four-year college degree in medical or business field
- Understanding of medical terminology
- Proficiency in Microsoft Access
About the Company
Luminare Health, a wholly owned subsidiary of Health Care Service Corporation (HCSC), is a leading third-party administrator dedicated to making healthcare simpler, better, and more affordable for clients and their members.
#J-18808-LjbffrVacancy posted 2 days ago
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