Sr Claims Analyst - LHB
At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job Summary
This position includes a variety of claim administrative and technical tasks that support a Claim Unit and/or vendor staff, as well as the Claims Team and serves as a liaison for any internal departments.
In addition to these tasks, the Senior Claims Analyst is responsible for all of the same tasks as a Claim Analyst including the accurate adjudication and processing of medical, dental, vision, or other related claims, including related correspondence and/or electronic inquiries for assigned groups. All claims and inquiries are handled according to the established plan documents, claim processing guidelines, and established total turnaround times. Also advise team members regarding claim processing procedures.
Life & Disability - Sr Claims Analyst
Secure and analyze claim information to make life and disability benefit determinations in accordance with policy provisions and appropriate state and federal laws; achieving results by effective use of all appropriate resources. Calculate benefit payments and communicate claim decisions on new and continuing claims. Provide responsive and caring customer service. All tasks completed under general supervision of management.
Required Job Qualifications:
• High School diploma or GED equivalent
• 3 years prior medical claim processing experience
• Ability to work in a fast-paced, customer centric & production driven environment
• Excellent verbal and written communication skills
• Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff
• Demonstrated critical thinking, to carry out instructions furnished in oral, written or diagram form
• Flexible; open to continued process improvements
• Self-directed individual who works well with minimal supervision
• Good leadership, organizational and interpersonal skills
• Ability to effectively handle with complex situations and reach resolution
• Ability to analyze and interpret documents and Summary Plan Descriptions (SPDs)
• Ability to adapt to various system platforms, and to effectively use MS Excel/Word
Preferred Job Qualifications:
• Health Insurance/Third Party Administrator Experience
• *This is a Telecommute (Remote) role. Candidates must live within the following states: IL, IN, IA, KS, MO, MT, NM, NC, OK, PA, TN, TX or WI**
Sponsorship is not available
#LI-NR1
#LI-Remote
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
EEO Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Pay Transparency Statement:
At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates .
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
Min to Max Range:
$17.71 - $33.25
Exact compensation may vary based on skills, experience, and location.
Apply tot his job
Apply To this Job
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job Summary
This position includes a variety of claim administrative and technical tasks that support a Claim Unit and/or vendor staff, as well as the Claims Team and serves as a liaison for any internal departments.
In addition to these tasks, the Senior Claims Analyst is responsible for all of the same tasks as a Claim Analyst including the accurate adjudication and processing of medical, dental, vision, or other related claims, including related correspondence and/or electronic inquiries for assigned groups. All claims and inquiries are handled according to the established plan documents, claim processing guidelines, and established total turnaround times. Also advise team members regarding claim processing procedures.
Life & Disability - Sr Claims Analyst
Secure and analyze claim information to make life and disability benefit determinations in accordance with policy provisions and appropriate state and federal laws; achieving results by effective use of all appropriate resources. Calculate benefit payments and communicate claim decisions on new and continuing claims. Provide responsive and caring customer service. All tasks completed under general supervision of management.
Required Job Qualifications:
• High School diploma or GED equivalent
• 3 years prior medical claim processing experience
• Ability to work in a fast-paced, customer centric & production driven environment
• Excellent verbal and written communication skills
• Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff
• Demonstrated critical thinking, to carry out instructions furnished in oral, written or diagram form
• Flexible; open to continued process improvements
• Self-directed individual who works well with minimal supervision
• Good leadership, organizational and interpersonal skills
• Ability to effectively handle with complex situations and reach resolution
• Ability to analyze and interpret documents and Summary Plan Descriptions (SPDs)
• Ability to adapt to various system platforms, and to effectively use MS Excel/Word
Preferred Job Qualifications:
• Health Insurance/Third Party Administrator Experience
• *This is a Telecommute (Remote) role. Candidates must live within the following states: IL, IN, IA, KS, MO, MT, NM, NC, OK, PA, TN, TX or WI**
Sponsorship is not available
#LI-NR1
#LI-Remote
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
EEO Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Pay Transparency Statement:
At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates .
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
Min to Max Range:
$17.71 - $33.25
Exact compensation may vary based on skills, experience, and location.
Apply tot his job
Apply To this Job