Claims Analyst

🔥 1 hour ago

🇺🇸 United States – Remote

💵 $14 - $28 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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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

• responsible for the accurate adjudication and processing of medical, dental, vision, or other related claims • calculate benefit payments and communicate claim decisions on new and continuing claims within established turnaround times • provide responsive and caring customer service

🎯 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 instructions furnished in oral, written or diagram form • Flexible; open to continued process improvement • Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word • 1 year 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) • An understanding of claims examining (Life & Disability) • Must have strong math and decision-making skills (Life & Disability) • Self-motivated with high learning agility (Life & Disability) • Must be a self-starter with strong time management skills (Life & Disability) • Capable of making decisions in the absence of specific directions with minimal supervision (Life & Disability) • Ability to effectively cope with change in a dynamic environment (Life & Disability) • Must display a strong commitment to teamwork (Life & Disability) • Proficiency in working with Word, Excel and Outlook (Life & Disability) • Four-year college degree in medical and/or business field (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