Senior Claims Analyst

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $18 - $33 / hour

⏰ Full Time

🟠 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

• Perform claim administrative and technical tasks supporting a Claim Unit and/or vendor staff, Claims Team, and internal departments • Act as a liaison for internal departments • Accurately adjudicate and process medical, dental, vision, or other related claims for assigned groups • Handle related correspondence and electronic inquiries according to established plan documents, claim processing guidelines, and turnaround times • Advise team members regarding claim processing procedures • Secure and analyze claim information to make life and disability benefit determinations in accordance with policy provisions and applicable state and federal laws • Calculate benefit payments and communicate claim decisions on new and continuing claims • Provide responsive and caring customer service • Complete tasks under general management supervision

🎯 Requirements

• High School diploma or GED equivalent • 3 years prior medical claim processing experience • Minimum three-years life and/or disability claim administration experience, or the equivalent combination of relevant experience • Ability to work in a fast-paced, customer centric and production driven environment • Excellent verbal and written communication skills • Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff • Demonstrated critical thinking, to carry out instructions furnished in oral, written or diagram form • 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 complex situations and reach resolution • Ability to analyze and interpret documents and Summary Plan Descriptions (SPDs) • Ability to adapt to various system platforms • Effective use of personal computers and related software • Proficiency in working with Word, Excel and Outlook; Access preferred • Strong math and decision-making skills • Must be able 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 • Capable of making decisions in the absence of specific directions, independently or 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 • Preferred: Four-year college degree in medical and/or business field • Understanding of medical terminology

🏖️ 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