Claims Analyst

🔥 19 hours ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $55k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 Ghost score 0%

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Alight Solutions

WebsiteLinkedInAll Job Openings

10,000+ employees

🤝 B2B

🏥 Healthcare

☁️ SaaS

💰 $22.5M Post-IPO Secondary - Alight Solutions on 2023-08

B2B • Healthcare • SaaS

Alight Solutions is a leading benefits administration provider that delivers health, wealth, leave, and related HR point solutions for large organizations and their employees. The company helps manage benefits administration and human capital-related processes for enterprises, serving many of the world’s largest organizations and over 30 million people. Alight also emphasizes product and technology roles, corporate sustainability, total rewards, and a focus on transforming lives and organizations by maximizing health, financial and work wellbeing.

📋 Description

• Leverage acquired knowledge to deliver high-quality, consultative customer interactions • Advocate for members by working with carriers, providers, and plan documentation • Resolve post-service coverage questions and issues accurately and timely • Review medical, dental, vision, and pharmacy claims for accuracy and proper benefit coverage • Coordinate with providers and carriers to resolve billing discrepancies, coding errors, and denied claims • Assist with claim resubmission as necessary • Draft, submit, and exhaust appeals processes as necessary • Partner with clients on unique care and billing situations requiring special review • Coordinate with providers to determine payment plan and discount options • Navigate internal tools and applications • Make external phone calls and conduct email and phone outreach • Work cases through resolution at the employee level

🎯 Requirements

• Bachelor’s Degree, Associate’s Degree with 2 years billing/insurance experience, or 3 years’ experience in a healthcare billing/insurance related role • Ability to work effectively in a remote team environment • Strong problem solving, reasoning, and analytical skills • Exceptional verbal and written communication skills • Ability to articulate complex billing concepts to non-expert members • Strong ability and desire to learn continually in a changing environment • Ability to efficiently organize work activities to meet deadlines • Passion to provide the highest level of client satisfaction • Ability to receive and immediately apply constructive feedback • Ability to develop effective rapport with clients based on empathy and trust • Successful completion of a background check, as applicable • Must have work authorization in the Employing Country without current or future visa sponsorship required • Preferred: expertise and current knowledge of Medicare, FSA, HRA, HSA, and claims adjudication process

🏖️ Benefits

• Health, dental and vision coverages starting Day One • Wellbeing programs • Retirement plans with contribution matching • Generous time off • Parental leave • Continuing education • Career growth opportunities • Full benefits package starting on first day of employment • Life insurance • 401k plan with corporate match • Paid Time Off • Ongoing training, coaching and development • Flexible working arrangements wherever possible • Reasonable accommodations for disabilities and sincerely held religious beliefs