Senior Claims Analyst - Process & Issue Resolution

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

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.