Health Claims Analyst

Job Summary

Working remotely in a full-time capacity, the Phone Claims Analyst will evaluate and process health claims through inbound and outbound calls, ensuring compliance with regulations while delivering exceptional customer service.

Key responsibilities

• Accurately determine claim benefits payable based on medical information and contract language
• Communicate with internal and external customers to finalize claims and explain claim handling processes
• Provide effective customer service via phone and written correspondence, utilizing service recovery techniques to enhance customer experience

Required qualifications

• Ability to work independently and collaboratively in a team environment
• Working understanding of computer systems, including email and data entry
• Effective oral, written, and interpersonal communication skills
• Ability to assess customer needs and demonstrate flexibility in responses
• Access to a high-speed internet connection and located in the United States or Puerto Rico