Claims Analyst

🔥 14 hours 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.

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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

• Analyze health, life, and disability claims • Examine and investigate claims using analytical and organizational skills • Apply math and decision-making skills to claims determinations • Manage and follow up on numerous tasks while prioritizing workload and meeting deadlines • Use Word, Excel, Outlook, and related computer software • Work with team members, employees/members, providers, and clients • Adapt to changing processes, system platforms, and dynamic work environments • Contribute to a collaborative, customer-centric, production-driven team

🎯 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 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 and Word • 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 • 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 • 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