Claims Research Analyst

Job Summary

Serving as a claims subject matter expert, the full-time Claims Research Analyst will manage complex claims projects, conduct in-depth research and analysis to address claims processing issues, and collaborate with various departments to ensure regulatory compliance and improve overall claims performance.

Key responsibilities

• Conducts research and analysis to resolve high-priority claims inquiries and projects
• Interprets and presents claims research findings to leadership and operations teams
• Identifies and remediates claims processing errors to reduce rework and improve efficiency

Required qualifications

• At least 3 years of medical claims processing experience or equivalent education and experience
• Experience with claims processing related to Medicare, Medicaid, and Marketplace programs
• Strong data research and analysis skills
• Proficiency in Microsoft Office suite, including Excel
• Ability to manage multiple projects and tasks simultaneously