Claim Analyst

Randstad USA; Tampa (FL); On-site; USD 40,000 - 55,000; Full time

Job summary

A staffing and consulting company is seeking a meticulous Claim Analyst for a 6-month contract role in Tampa, FL. You will manage dental and vision insurance claims, ensuring accuracy and timely processing. The ideal candidate has strong analytical skills and experience in claims processing, with a commitment to maintaining HIPAA standards. Join us to improve workflow and enhance department productivity.

Qualifications

• Strong attention to detail and analytical skills.
• Ability to follow documented policies and procedures.
• Experience in claims processing or a related field is a plus.
• Dental and Vision preferred.
• Knowledge of HIPAA standards and a commitment to maintaining patient privacy.

Responsibilities

• Process claims according to company policies and procedures.
• Verify the accuracy of information entered into the claims system software.
• Approve or deny claims, ensuring fees and proper authorizations are submitted.
• Resolve claims issues by researching claim situations.
• Maintain the accuracy of member coverage information.

Skills

Attention to detail

Analytical skills

Communication skills

Problem-solving abilities

Job description

About the Role

Randstad is seeking a meticulous and dedicated Claim Analyst to join our team in Tampa, FL. This contract role, which has a 6-month term with the possibility of extension, is responsible for managing a caseload of dental and vision insurance claims, ensuring their accuracy, validity, and timely processing. In this position, you will also have the opportunity to be considered for an internal role with this team.

Key Responsibilities

• Process claims according to company policies and procedures.
• Verify the accuracy of information entered into the claims system software.
• Review claims and attached documentation for completeness and accuracy to determine payment.
• Approve or deny claims, ensuring fees and proper authorizations are submitted.
• Resolve claims issues from the Customer Service department by researching claim situations and providing timely responses.
• Identify trends in provider or member issues and recommend solutions to management.
• Maintain the accuracy of member coverage information by reporting discrepancies to the membership department.
• Recommend improvements to workflow and organizational structure to enhance department productivity.
• Ensure the completeness and accuracy of Standard Operating Procedures by providing feedback to the department manager.
• Maintain all levels of member privacy in accordance with HIPAA standards.

Required Skills & Experience

• Strong attention to detail and analytical skills.
• Ability to follow documented policies and procedures.
• Experience in claims processing or a related field is a plus.
• Dental and Vision preferred.
• Excellent communication and problem-solving abilities.
• Knowledge of HIPAA standards and a commitment to maintaining patient privacy.