Claims Analyst

Alight•Virtual, TX

1d•Remote

About The Position

We are now hiring ambitious, motivated Claim Analysts to work in our team focused, premier healthcare navigation business. In this role, you will be leveraging acquired knowledge to deliver high quality customer interactions that are consultative and lead to better healthcare outcomes. Through this role, you will have the opportunity to positively impact the lives of employee customers and their families, while driving increased benefit satisfaction and reducing healthcare spend for their employers.

Requirements

Bachelor’s Degree, Associate’s Degree with 2 years billing/insurance experience, or 3 years’ experience in a healthcare billing/insurance related role
Ability to work effectively in a remote team environment
Strong problem solving, reasoning, and analytical skills
Exceptional verbal and written communication skills – ability to articulate complex billing concepts for members that are not experts
Strong ability and desire to learn continually in a changing environment
Ability to efficiently organize work activities to meet deadlines
Passion to provide the highest level of client satisfaction
Ability to receive and immediately apply constructive feedback
Ability to develop effective rapport with clients based on empathy and trust

Nice To Haves

Expertise and current knowledge of Medicare, Health accounts (FSA, HRA, HSA), and claims adjudication process

Responsibilities

Assist in reviewing medical, dental, vision, and pharmacy related claims for accuracy to ensure members are receiving the proper benefit coverage according to plan stipulations
Coordinate with providers and carriers to solve billing discrepancies, coding errors, and denied claims; assist with claim resubmission, as necessary
Draft, submit, and exhaust appeals processes, as necessary
Partner directly with client to bring awareness to unique care/billing situations that may require special review
Coordinate with providers to determine payment plan and discount options