Claims Analyst

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $14 - $28 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Accurately adjudicate and process medical, dental, vision, life, disability, or other related claims for assigned groups • Handle related correspondence and electronic inquiries • Process claims according to established plan documents and claim processing guidelines • Meet established total turnaround times • Examine claims and conduct investigations • Make analytical and claims-related decisions with minimal supervision • Prioritize workload, manage and follow up on numerous tasks • Collaborate with team members, employees/members, providers, and clients • Adapt to process improvements, system platforms, and changing priorities

🎯 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, adapt to various system platforms, and effectively use MS Excel/Word • An understanding of claims examining • Solid investigation, analytical and organizational skills, and 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 • Self-starter with strong time management skills to prioritize workload, manage and follow up on numerous tasks • Capable of making decisions in the absence of specific directions with minimal supervision • Ability to effectively cope with change and shift gears accordingly 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 • 1 year of health insurance experience (preferred) • Self-Funded Insurance/Benefits and/or TPA experience (preferred) • Knowledge of medical procedure and diagnosis coding (preferred) • Knowledge of medical terminology (preferred) • Familiarity with Summary Plan Documents (SPDs), insurance booklets, or other benefit descriptive tools (preferred) • Four-year college degree in medical and/or business field (preferred) • Life and/or disability claim knowledge (preferred) • Proficiency in Microsoft Access (preferred)

🏖️ Benefits

• Health and wellness benefits • 401(k) savings plan • Pension plan • 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 the terms and conditions of the plan