Health Claims Analyst

Job Summary

Working remotely on a full-time basis, the Supplemental Health Claims Analyst will manage inbound and outbound calls to accurately evaluate claims, ensuring compliance with regulations while delivering exceptional customer service.

Key responsibilities

• Determine claim benefits payable based on medical information and contract language, adhering to established policies and procedures
• Communicate with internal and external customers to gather claim information and explain claim handling, fostering strong relationships
• Provide effective customer service through multiple channels, resolving requests and ensuring a positive customer experience

Required qualifications

• Ability to work independently and collaboratively in a team environment
• Proficient in computer systems, including data entry and Microsoft products
• Strong organizational and time management skills with a focus on detail
• Demonstrated ability to assess customer needs and customize responses effectively
• Access to high-speed internet and located in the United States or Puerto Rico