Claims Analyst

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $14 - $28 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 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

Luminare Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Luminare Health is a leading provider of self-funded health plan administration services with over 50 years of industry experience. The company specializes in offering flexible and innovative solutions for hospitals, health systems, and direct-to-employer initiatives, focusing on administration, cost management, and digital reporting tools. Luminare Health is dedicated to being a reliable partner in managing healthcare costs and supporting strategic growth for its clients. The company emphasizes a member-centered approach to healthcare while delivering significant savings through expert claim analysis and management of high-cost claims.

📋 Description

• Accurately adjudicate and process medical, dental, vision, life, disability, or 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 • Investigate claims and make analytical, mathematical, and claims-examining decisions • Prioritize workload, manage and follow up on numerous tasks • Work 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 instructions furnished in oral, written or diagram form • Flexible; 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 in a collaborative environment • Effective use of personal computers and related software • Proficiency in Word, Excel and Outlook • Preferred: 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: Four-year college degree in medical and/or business field • Preferred: Life and/or Disability claim knowledge • Preferred: Proficiency in Microsoft Access

🏖️ 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