Senior Claims Analyst

Job Summary

Working remotely on a full-time basis, the Senior Claims Analyst will manage complex claim adjudication processes, resolve escalated client and provider issues, and mentor junior analysts while ensuring compliance with established guidelines.

Key responsibilities:

• Resolve escalated claims issues for clients, employees, and providers
• Review and release over-authority claims while advising team members on claim processing procedures
• Support the Claims reinsurance team in researching and resolving claims as assigned

Required qualifications:

• High School diploma or GED equivalent
• 3 years prior medical claim processing experience
• Ability to work in a fast-paced, customer-centric environment
• Demonstrated critical thinking and problem-solving skills
• Self-directed individual who works well with minimal supervision