Claims Analyst

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $14 - $28 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 Ghost score 0%

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CareAllies

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2016

🏥 Healthcare

🤝 B2B

Healthcare • B2B

CareAllies is a healthcare services company that helps physician organizations and health plans succeed in value-based care. It provides business advisory, care coordination, practice and network management, and data/technology support to independent physician associations (IPAs), ACOs, clinically integrated networks and other provider groups. CareAllies focuses on operationalizing value-based contracts (from pay-for-performance to full risk), reducing administrative burden for clinicians, improving patient outcomes, and supporting growth and retention for providers and health plans across commercial, Medicare, and Medicare Advantage arrangements.

📋 Description

• Accurately adjudicate and process medical, dental, vision, and other related claims for assigned groups • Handle related correspondence and electronic inquiries • Process all claims and inquiries according to established plan documents and claim processing guidelines • Meet established total turnaround times • Examine claims and conduct investigations • Make decisions with minimal supervision and in the absence of specific directions • Prioritize workload, manage and follow up on numerous tasks • Adapt to changing processes and dynamic work environments • Collaborate with team members, employees/members, providers, and clients

🎯 Requirements

• High School diploma or GED equivalent • Ability to work in a fast-paced, customer centric and production driven environment • Effective verbal and written communication skills • Ability to work effectively with team members, employees/members, providers, and clients • Ability to use common sense understanding to carry out oral, written, or diagram-form instructions • Flexible and open to continued process improvement • Ability to learn new/proprietary systems and adapt to various system platforms • Effective use of MS Excel/Word • An understanding of claims examining • Solid investigation, analytical, and organizational skills • Attention to detail • Strong math and decision-making skills • Ability to work in a deadline-driven, fast-paced environment • Self-motivated with high learning agility • Excellent verbal and written communication skills with a passion for helping others • Strong time management skills to prioritize workload, manage and follow up on numerous tasks • Ability to make decisions with minimal supervision • Ability to cope with change and shift gears in a dynamic environment • Strong commitment to teamwork and ability to work collaboratively • Effective use of personal computers and related software • Proficiency in Word, Excel, and Outlook

🏖️ Benefits

• Curated development plans • Health and wellness benefits • 401(k) savings plan • Pension plan • Minimum of 15 days’ paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Other incentives • Annual incentive bonus plan subject to plan terms and conditions