Claims Analyst III

Modivcare; United States; Remote; USD 61,000 - 80,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) with company match

Paid time off

Parental leave

Disability insurance

Tuition reimbursement

Employee discounts

Job summary

Modivcare is seeking a seasoned claims analyst to implement efficient claims processes and ensure accuracy across systems. The role audits claim data, identifies irregularities, and collaborates with systems design to deploy new features.

You will review claims, request missing information, resolve discrepancies, mentor junior staff, and participate in other projects as needed. Salary ranges from $60,800 to $80,000 with strong benefits.

Qualifications

• Bachelor's Degree required.
• Five (5) plus years of experience or equivalent.
• Strong understanding of claims processing and ability to decide claim eligibility.
• Excellent attention to detail and data entry for accurate processing.
• Intermediate proficiency with Word, Excel, Outlook.
• Analytical mindset to interpret claim data and follow guidelines.
• Excellent verbal and written communication with customer-focused demeanor.
• Problem-solving abilities to address claim issues and discrepancies.
• Ability to work independently and in a team.
• Typing 35 words per minute and use of 10-key.

Responsibilities

• Reviews claims for irregularities, accuracy and completeness.
• Requests additional information for completion of claim processing.
• Coordinates and processes documentation, invoice dispute resolution and payment.
• Performs account analysis and researches payment and account discrepancies.
• Identifies and verifies transactions and expedites resolution of claims issues.
• Handles complex issues and refers only the most complex ones to higher-level staff.
• Possesses comprehensive knowledge of subject matter.
• Provides leadership, coaching, and mentoring to junior team members.
• Participate in other projects or duties as assigned.

Skills

Attention to detail

Data entry

Analytical mindset

Communication skills

Team player

Typing speed 35 wpm

10-key proficiency

Education

Bachelor's Degree

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you!

This positions is responsible for implementing claims processes to maximize effectiveness and accuracy. This includes auditing the accuracy of claims information entered in the system and monitoring the operation of the claims systems. In addition develops solutions to claims issues and works with systems design to implement new features. You will...

Responsibilities

• Reviews claims for irregularities, accuracy and completeness.
• Requests additional information, where necessary, for completion of claim processing.
• Coordinates and processes documentation, invoice dispute resolution and payment for accounts.
• Performs account analysis and researches payment and account discrepancies.
• Identifies and verifies transactions and expedites a resolution of various claims issues.
• Handles complex issues and problems, and refers only the most complex issues to higher-level staff.
• Possesses comprehensive knowledge of subject matter.
• Provides leadership, coaching, and/or mentoring to more junior team members.
• Participate in other projects or duties as assigned.

Qualifications

• Bachelor's Degree required.
• Five (5) plus years of experience. Or equivalent combination of education and/or experience.
• Strong understanding of claims processing and ability to make informed decisions on claim eligibility.
• Excellent attention to detail and proficient data entry skills for accurate claim processing.
• Intermediate proficiency of Microsoft applications (Word, Excel, and Outlook).
• Analytical mindset with the ability to interpret claim data and follow established guidelines.
• Excellent verbal and written communication skills to interact with superior customer-focused demeanor.
• Problem-solving abilities to address claim issues and resolve discrepancies.
• Ability to work independently and as a member of a team.
• Ability to accurately type 35 words per minute and use of 10-key.

Salary: $60,800-$80,000

The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of the position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job. Primarily seated work; extensive computer and telephone use; occasional standing, walking, reaching, bending, and lifting up to 10 lbs.

Modivcare’s positions are posted and open for applications for a minimum of 5 days.

Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received.

Benefits

• Medical, Dental, and Vision insurance
• Employer Paid Basic Life Insurance
• AD&D Voluntary Life Insurance (Employee/Spouse/Child)
• Health Care and Dependent Care Flexible Spending Accounts
• Pre-Tax and Post --Tax Commuter and Parking Benefits
• 401(k) Retirement Savings Plan with Company Match
• Paid Time Off
• Paid Parental Leave
• Short-Term and Long-Term Disability
• Tuition Reimbursement
• Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)

Modivcare is an Equal Opportunity Employer. EEO is The Law - click here for more information Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law.

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