Claims Research Analyst

Job Summary

Providing analytical support for claims research activities, the full-time Claims Research Analyst will review and research claims to ensure compliance with regulatory requirements, identify processing errors, and coordinate remediation plans in a remote setting.

Key responsibilities

• Conducts in-depth research and analysis to address high-priority claims inquiries and projects
• Manages major claims projects, ensuring timely identification and remediation of claims processing issues
• Collaborates with internal and external stakeholders to define claims requirements and improve overall claims performance

Required qualifications

• At least 3 years of medical claims processing experience or equivalent combination of education and experience
• Experience with claims processing related to Medicare, Medicaid, and Marketplace government-sponsored programs
• Strong data research and analysis skills
• Proficiency in Microsoft Office suite, particularly Excel
• Ability to manage multiple projects and tasks in a highly matrixed organization