Senior Claims Analyst

Job Summary

Overseeing the claims processing functional areas, the full-time Senior Claims Analyst will coordinate and monitor all aspects of claims processing and reprocessing, facilitating communication with providers and members to resolve claims issues in a remote work environment.

Key responsibilities

• Coordinate and monitor claims processing for designated lines of business or specialty functions
• Facilitate communication with providers and members to enhance understanding and resolve claims issues
• Oversee the reprocessing of claims as necessary to ensure accurate and timely adjudication

Required qualifications

• High school diploma or equivalent required
• Five years of experience in claims processing/adjudication, provider billing, or health plans required
• Experience in medical terminology and ICD-10/CPT coding required
• Leadership experience can substitute for up to two years of required experience
• Experience in computerized managed care systems preferred