Senior Claims Analyst & Process Improvement

ModivCare Solutions, LLC; United States; Remote; USD 61,000 - 80,000; Full time

Benefits offered by this job

Medical, Dental, and Vision insurance

Employer Paid Basic Life Insurance and

AD&D Voluntary Life Insurance (EMP/SPO

Health Care and Dependent Care FSAs

Commuter and Parking Benefits

401(k) Retirement Savings Plan with 1:

Paid Time Off

Paid Parental Leave

Short-Term and Long-Term Disability

Tuition Reimbursement

Employee Discounts

Job summary

Modivcare is seeking a seasoned claims processor to implement and audit claims processes, maximize accuracy, and support system enhancements. You will review claims for irregularities, request information when needed, and coordinate documentation and payments while mentoring junior staff.

The role requires a Bachelor's degree and 5+ years of experience in claims processing, with strong Excel/Outlook skills and excellent communication. Equal opportunity employer.

Qualifications

• Bachelor's Degree required.
• 5+ years of experience or equivalent combination.
• Strong understanding of claims processing and eligibility.
• Excellent attention to detail and data entry skills.
• Intermediate proficiency of Microsoft applications (Word, Excel, and Outlook).
• Analytical mindset to interpret claim data and guidelines.
• Excellent verbal and written communication skills.
• Ability to work independently and in a team.
• Type 35 words per minute and 10-key proficiency.

Responsibilities

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

Skills

Bachelor's Degree

5+ years experience

Attention to detail

Data entry skills

Analytical mindset

Verbal and written communication

Team player

Typing 35 wpm & 10-key

Education

Bachelor's Degree

Tools

Microsoft Office

Job description

Modivcare is seeking a seasoned claims processor to implement and audit claims processes, maximize accuracy, and support system enhancements. You will review claims for irregularities, request information when needed, and coordinate documentation and payments while mentoring junior staff.

The role requires a Bachelor's degree and 5+ years of experience in claims processing, with strong Excel/Outlook skills and excellent communication. Equal opportunity employer.