Claims Analyst

🔥 18 hours ago

🐻 Alaska, California, +2 more states – Remote

🐻 Alaska – Remote 🏄 California – Remote 🌺 Hawaii – Remote 🗽 New York – Remote

💵 $14 - $28 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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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 claims and conduct investigations • Apply analytical, organizational, mathematical, and decision-making skills to claims work • Manage and follow up on numerous tasks while meeting deadlines • Use Word, Excel, Outlook, and proprietary systems • Adapt to various system platforms and process improvements • Make decisions with minimal supervision • Collaborate with team members, employees/members, providers, and clients • Support a customer-centric, production-driven claims operation

🎯 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 carry out oral, written, or diagrammed instructions using common sense • Flexible and open to continued process improvement • Ability to learn new/proprietary systems, adapt to various system platforms, and effectively use MS Excel/Word • 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 • 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 • Strong time management skills and ability 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 • Commitment to teamwork and ability to work collaboratively • Effective use of personal computers and related software • Proficiency with Word, Excel, and Outlook • Preferred: Four-year college degree in medical and/or business field • Preferred: Life and/or Disability claim knowledge • Preferred: Knowledge of medical terminology • Preferred: Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools • Preferred: Proficiency with 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

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