Claims Analyst - Medical Claims

At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job SummaryThe Claims Analyst is responsible for the accurate adjudication and processing of medical, dental, vision, or other related claims, including related correspondence and/or electronic inquiries for assigned groups. All claims and inquiries are handled according to the established plan documents, claim processing guidelines, and established total turnaround times.

Required Job Qualifications:

• 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, to adapt to various system platforms, and to effectively use MS Excel/Word

** This role is based remotely, however candidates must live in one the following states: IL, MT, IN, IA, KS, MO, NC, NM, OK, PA, TX or WI **

Preferred Job Qualifications:

• 1 year Health Insurance experience
• Self-Funded Insurance/Benefits and/or TPA experience
• Knowledge of medical procedure and diagnosis coding
• Knowledge of medical terminology
• Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

EEO Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Pay Transparency Statement:

At Luminare Health, you will be part of an organization committed to offering meaningful benefits to our associates to support their life outside of work. From health and wellness benefits, 401(k) savings plan, a minimum of 15 days’ of paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, new parent paid leave, tuition reimbursement, plus other incentives, we offer a robust total rewards package for full-time associates.

 

The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan.

Min to Max Range:

$14.32 - $26.90 Apply