BusinessOperations - Claims Analyst 2 Claims Analyst 2

Mindlance; Rocky Mount (NC); Remote; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a detail-oriented Claims Analyst to join their team. In this role, you will be responsible for processing medical claims, ensuring that all information is accurate and up-to-date for reimbursement eligibility. You will play a crucial role in authorizing payments, coordinating investigations, and providing exceptional customer service to clients navigating the claims process. With opportunities for growth and development, this position offers a chance to make a significant impact in a supportive and dynamic environment. If you have a passion for problem-solving and a keen eye for detail, this could be the perfect opportunity for you.

Qualifications

• 2-4 years of experience in claims processing or related field.
• Strong knowledge of insurance policies and claims management.

Responsibilities

• Process medical claims and verify information for reimbursement eligibility.
• Authorize claim payments and coordinate investigations on claims.

Skills

Claims Processing

Customer Service

Data Entry

VLookup

Pivot Tables

Education

High School Diploma or GED

Bachelor’s Degree in Business or Related Field

Job description

Job Description: Summary: The main purpose of a Claims analyst is to process pended medical claims, verifying and updating information on submitted claims and reviewing work processes to determine reimbursement eligibility. Ensure payments and/or denials are made in accordance with company practices and procedures.

Job Responsibilities: Organize and work with detailed office or warehouse records, using computer to enter, access, search and retrieve data. Prepare and review insurance claim forms and related documents for completeness. Provide customer service, such as giving limited instructions on how to proceed with claims or providing referrals to other facilities or contractors. Review claims to determine whether or not claimant is covered under a policy, review policy to determine coverage, and evaluate the extent of a settlement. Authorize claim payments, set reserves on payments, ensure timely disbursement of funds, coordinate or conduct investigations on claims, identify claims with possible recovery from third parties, and consult with attorneys, doctors, and agents regarding the disposition of complex claims.

Education/Experience: High school diploma or GED required. Bachelor’s degree in Business or related field preferred. 2-4 years experience required.

Additional Requirements: Experience with VLookup and pivot tables is desired. Candidate location anywhere in EST zone for remote position.

EEO Statement: “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”