Senior Claims Analyst

Remotedxb; Dubai; On-site; AED 60,000 - 120,000; Full time

Job summary

Luminare Health in Dubai is seeking an experienced Claims Processor to adjudicate and process medical, dental, vision, and related claims, ensuring accuracy and compliance. You will secure and analyze claim information to determine life and disability benefit eligibility.

The role requires high school diploma and 3 years medical claim processing and 3 years life/disability administration, proficiency in MS Office, strong math and decision-making skills, and the ability to interpret SPDs.

Qualifications

• 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).

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

Skills

Decision making

Math skills

Customer service

Education

High School diploma or GED

Four-year college degree (medical or business)

Tools

MS Excel

MS Word

Outlook

MS Access

Job description

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.