Claims Analyst III

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $60.8k - $80k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Modivcare

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2017

🏥 Healthcare

⚕️ Healthcare Insurance

🚗 Transport

💰 $525M Post-IPO Debt on 2024-07

Healthcare • Healthcare Insurance • Transport

Modivcare is a company that focuses on simplifying the experience of living with complex healthcare needs by providing a comprehensive suite of supportive care solutions. They specialize in non-emergency medical transportation, personal care, and virtual & remote patient monitoring. Modivcare works closely with Medicaid Plans, State Agencies, Medicare Advantage, SNP Plans, health systems, healthcare professionals, and transportation providers, ensuring that members receive necessary health services. Through innovative technology and data-driven strategies, they address social determinants of health by offering services like quality transportation, chronic care management, meal delivery, and in-home assistance, aimed at optimizing patients' health outcomes and improving their overall experience.

📋 Description

• Implement claims processes to maximize effectiveness and accuracy • Audit the accuracy of claims information entered in the system • Monitor the operation of claims systems • Develop solutions to claims issues and work with systems design to implement new features • Review claims for irregularities, accuracy, and completeness • Request additional information when necessary for claim processing • Coordinate and process documentation, invoice dispute resolution, and payment for accounts • Perform account analysis and research payment and account discrepancies • Identify and verify transactions and expedite resolution of claims issues • Handle complex issues and refer only the most complex issues to higher-level staff • Provide leadership, coaching, and/or mentoring to more junior team members • Participate in other projects or duties as assigned

🎯 Requirements

• Bachelor's Degree required, or equivalent combination of education and/or experience • Five (5) plus years of experience • Strong understanding of claims processing and ability to make informed decisions on claim eligibility • Excellent attention to detail and proficient data entry skills for accurate claim processing • Intermediate proficiency of Microsoft applications (Word, Excel, and Outlook) • Analytical mindset with the ability to interpret claim data and follow established guidelines • Excellent verbal and written communication skills to interact with superior customer-focused demeanor • Problem-solving abilities to address claim issues and resolve discrepancies • Ability to work independently and as a member of a team • Ability to accurately type 35 words per minute and use of 10-key

🏖️ Benefits

• Medical, Dental, and Vision insurance • Employer Paid Basic Life Insurance and AD&D • Voluntary Life Insurance (Employee/Spouse/Child) • Health Care and Dependent Care Flexible Spending Accounts • Pre-Tax and Post-Tax Commuter and Parking Benefits • 401(k) Retirement Savings Plan with Company Match • Paid Time Off • Paid Parental Leave • Short-Term and Long-Term Disability • Tuition Reimbursement • Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)