Sr Claims Analyst

Remotedxb; Dubai; On-site; AED 89,000 - 156,000; Full time

Job summary

Luminare Health in Dubai seeks an experienced Medical Claims Processor to adjudicate and process medical, dental, vision, and life/disability claims with accuracy.

You will analyze claim information to determine benefit eligibility based on policy provisions and laws, calculate payments, and communicate decisions while providing responsive service to members and providers.

Qualifications

• High School diploma or GED required.
• 3 years of medical claim processing experience.
• Ability to work in a fast-paced, production-driven environment.
• Strong verbal and written communication skills.
• Ability to analyze and interpret SPDs.
• Proficiency with MS Excel and Word.

Responsibilities

• Adjudicate and process medical, dental, vision, and life/disability claims accurately.
• Analyze claim information to make benefit determinations based on policy provisions and laws.
• Calculate benefit payments and communicate decisions on new and continuing claims.
• Serve as a liaison for internal departments and advise team members on processing procedures.
• Provide responsive and caring customer service to members and providers.

Skills

Strong verbal and writtencommunication

Medical claim processing experience

SPD analysis

MS Excel

MS Word

Education

High School diploma or GED

Bachelor’s degree in medical or business field

Tools

MS Excel

MS Word

Job description

Responsibilities

• Adjudicate and process medical, dental, vision, and life/disability claims accurately
• Analyze claim information to make benefit determinations based on policy provisions and laws
• Calculate benefit payments and communicate decisions on new and continuing claims
• Serve as a liaison for internal departments and advise team members on processing procedures
• Provide responsive and caring customer service to members and providers

Requirements

• High School diploma or GED equivalent
• 3 years of prior medical claim processing experience
• Ability to work in a fast-paced, production-driven environment
• Strong verbal and written communication skills
• Ability to analyze and interpret Summary Plan Descriptions (SPDs)
• Proficiency with MS Excel and Word

Preferred Qualifications

• Four-year college degree in a medical or business field
• Experience with Health Insurance or Third Party Administrators (TPA)
• Understanding of medical terminology

Benefits

• Health and wellness benefits
• 401(k) savings and pension plan
• Paid time off and paid parental leave
• Disability and supplemental life insurance
• Tuition reimbursement

About the Company

Luminare Health is part of HCSC, an industry leader dedicated to expanding access to high-quality, cost-effective health care and reimagining health care delivery for Americans.