Claims Analyst

Job Summary

Working remotely in a full-time capacity, the Claims Analyst will manage inbound and outbound calls to ensure accurate evaluation of claims while adhering to regulations and delivering exceptional customer service.

Key responsibilities

• Accurately determine claim benefits payable based on medical information and contract language while maintaining production and quality standards
• Communicate with internal and external customers to gather claim information and explain claim handling processes, fostering strong relationships
• Provide effective customer service through various channels, employing service recovery techniques to resolve requests and enhance the customer experience

Required qualifications

• Proficient in computer systems, including email and data entry, with strong keyboarding skills
• Ability to work independently and collaboratively in a team environment
• Demonstrated effective organizational and time management skills
• Understanding of customer needs with flexibility in approach to resolve requests
• Located in the United States or Puerto Rico with access to high-speed internet