Connecticut Licensed Claims Analyst

Job Summary

A company is looking for an Analyst, Claims Research (Remote).

Key Responsibilities

• Conducts research and analysis on claims to ensure regulatory compliance and identifies root causes of processing errors
• Manages major claims projects and collaborates with internal and external stakeholders to define claims requirements
• Implements remediation plans and monitors claims reprocessing to improve overall claims performance

Required Qualifications

• At least 3 years of medical claims processing experience or equivalent education and experience
• Experience with claims processing across multiple states, markets, and claim types
• Knowledge of claims processing related to Medicare, Medicaid, and Marketplace programs
• Data research and analysis skills
• Proficiency in Microsoft Office suite, including Excel