Claims Analyst

Job Summary

A company is looking for a Claims Analyst responsible for the accurate adjudication and processing of various claims.

Key Responsibilities

• Review, analyze, and interpret claim forms and related documents to determine benefit coverage
• Investigate, pend, and refer claims based on established procedures and guidelines
• Support internal departments and communicate with various stakeholders to ensure proper claim processing

Required Qualifications

• High School diploma or GED equivalent
• Ability to work in a fast-paced, customer-centric, and production-driven environment
• 1 year of Health Insurance experience preferred
• Knowledge of medical procedure and diagnosis coding preferred
• Familiarity with Summary Plan Documents (SPDs) or other benefit descriptive tools preferred