Financial Services Representative
Logix Federal Credit Union
Claims Analyst
Health Care Service Corporation
full-time
Posted on:
Origin: • 🇺🇸 United States • Illinois, Iowa, Kansas, Montana
Visit company websiteSalary
💰 $15 - $28 per hour
Job Level
Junior
About the role
- 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
- The Claims Analyst is responsible for 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.
- Life & Disability claims: securing and analyzing claim information to make accurate benefit determinations on disability claims or other claim types as assigned, calculate benefit payments and communicate claim decisions, provide responsive and caring customer service.
Requirements
- High School diploma or GED equivalent
- Ability to work in a fast-paced, customer centric and production driven environment
- Effective verbal and written communication skills
- Ability to work effectively with team members, employees/members, providers, and clients
- Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form
- Flexible; open to continued process improvement
- Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word
- Preferred: 1 year Health Insurance experience
- Self-Funded Insurance/Benefits and/or TPA experience
- Knowledge of medical procedure and diagnosis coding
- Knowledge of medical terminology
- Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools
- Life & Disability specific: understanding of claims examining; solid investigation, analytical and organizational skills
- Strong math and decision-making skills
- Self-motivated with high learning agility
- Excellent verbal and written communication skills with a passion for helping others
- Self-starter with strong time management skills
- Capable of making decisions in the absence of specific directions with minimal supervision
- Effective in the use of personal computers and related software
- Proficiency in Word, Excel and Outlook
- Preferred: Four-year college degree in medical and/or business field
- Life and/or Disability claim knowledge
- Knowledge of medical terminology
- Familiarity with SPDs
- Proficiency in Microsoft Access
