Senior Claims Analyst

🔥 2 minutes ago

🇺🇸 United States – Remote

💵 $18 - $33 / hour

⏰ Full Time

🟠 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

• Secure and analyze claim information to make life and disability benefit determinations in accordance with policy provisions and appropriate state and federal laws • Calculate benefit payments and communicate claim decisions on new and continuing claims • Provide responsive and caring customer service • Advise team members regarding claim processing procedures

🎯 Requirements

• High School diploma or GED equivalent • 3 years prior medical claim processing experience • Ability to work in a fast-paced, customer centric & production driven environment • Excellent verbal and written communication skills • Ability to work effectively with employees/members, providers, clients and differing levels of co-workers • Demonstrated critical thinking • Flexible; open to continued process improvements • Self-directed individual who works well with minimal supervision • Good leadership, organizational and interpersonal skills • Ability to effectively handle with complex situations and reach resolution • Ability to analyze and interpret documents and Summary Plan Descriptions (SPDs) • Ability to adapt to various system platforms, and to effectively use MS Excel/Word

🏖️ Benefits

• Health insurance • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Annual incentive bonus plan