Claims Analyst

Acrisure•San Diego, CA

2d•$25 - $32•Onsite

About The Position

Acrisure is seeking a Claims Analyst to join our growing SBMA team. SBMA, a third-party administrator, is an affordable ACA-compliant benefits provider to thousands of employers. Their goal is to simplify the complexity of providing employee benefits. SBMA is different because of its personal service, speed of implementation, and innovative approach to benefits coverage. The Claims Analyst role is essential to the Claims department at SBMA. They manage and process claims in all workflow queues to ensure processing times meet company turnaround times (TATs) and timely review and reprocessing of claims as indicated. The Claims Analyst II will perform administrative tasks and services to support the effective and efficient operations of the organization’s claims department. This position is essential to SBMA's success.

Requirements

Excellent verbal and written communication skills.
Proficient in HealthPac software.
Excellent interpersonal and customer service skills.
Proficient in Microsoft Office Suite or related software.
Excellent organizational skills and attention to detail.
Basic understanding of clerical procedures and systems such as record-keeping and filing.
Ability to work independently.
2+ years of HealthPac experience
2+ years of medical claims adjudication experience

Nice To Haves

Bachelor's degree preferred

Responsibilities

Process claims in designated workflow queues
Knowledge of repricing claims with Reference Based Pricing (RBP) and Qualifying Payment Amount (QPA)
Review of processed claims and reprocessing when necessary
Claims reporting – daily and weekly reporting
Stop pay, void and reissue of payments
Back-up group claims report requests
Axos claims check maintenance.
Electronic provider payment reconciliation.
Other responsibilities as needed