Claims Analyst

Health Care Service Corporation

Claims Analyst responsible for adjudicating medical claims at Luminare Health. Focused on accurate processing and benefit determination in a fast-paced, customer-centric environment.

Posted 7/30/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $15 - $28 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in claims adjudication and processing, with strong knowledge of medical terminology and coding. Proficient in customer service and effective communication, while adapting to various systems and maintaining high decision-making and time management skills.

Highest-signal resume keywords

Claims AdjudicationMedical TerminologyCustomer ServiceDecision-Making SkillsProficiency in MS Excel

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims ProcessingMedical Procedure CodingDiagnosis CodingBenefit CalculationClaims Examining

Soft Skills

Effective CommunicationTeamworkTime ManagementAdaptabilitySelf-Motivation

Tools & Technologies

MS ExcelMS WordMS Outlook

Industry Keywords

Health InsuranceSelf-Funded InsuranceTPA ExperienceSummary Plan DocumentsInsurance Booklets

About the role

Key responsibilities & impact

responsible for the accurate adjudication and processing of medical, dental, vision, or other related claims
calculate benefit payments and communicate claim decisions on new and continuing claims within established turnaround times
provide responsive and caring customer service

Requirements

What you’ll need

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
1 year Health Insurance experience (preferred)
Self-Funded Insurance/Benefits and/or TPA experience (preferred)
Knowledge of medical procedure and diagnosis coding (preferred)
Knowledge of medical terminology (preferred)
Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools (preferred)
An understanding of claims examining (Life & Disability)
Must have strong math and decision-making skills (Life & Disability)
Self-motivated with high learning agility (Life & Disability)
Must be a self-starter with strong time management skills (Life & Disability)
Capable of making decisions in the absence of specific directions with minimal supervision (Life & Disability)
Ability to effectively cope with change in a dynamic environment (Life & Disability)
Must display a strong commitment to teamwork (Life & Disability)
Proficiency in working with Word, Excel and Outlook (Life & Disability)
Four-year college degree in medical and/or business field (preferred)

Benefits

Comp & perks

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
other incentives