Claims Analyst – Health, Life, & Disability

eBacon•Phoenix, AZ

1d•$60,000 - $80,000•Hybrid

About The Position

We're looking for a detail-oriented Claims Analyst who thrives on hands-on data work. You'll analyze health, life, and disability insurance claims to uncover trends, identify cost drivers, and support strategic decisions. This is an individual contributor role — expect to spend significant time in Excel and SQL, manage multiple projects independently, and translate complex data into clear, actionable insights.

Requirements

2-5 years of hands-on experience in claims analysis, healthcare analytics, or financial analysis (insurance sector preferred)
Experience with health insurance terminology (CPT codes, ICD codes, EOBs, etc.)
Knowledge of claims adjudication processes and workflows
Understanding of ERISA regulations and compliance requirements
Advanced Excel skills including pivot tables, VLOOKUP/XLOOKUP, complex formulas, and data modeling
Proficiency in SQL for querying databases and manipulating large datasets
Must be legally authorized to work in the United States without the need for employer sponsorship.

Responsibilities

Audit and analyze claims to ensure accurate documentation, appropriate coverage determination, and timely exposure identification.
Manage all email and phone correspondence with clients and provider agents regarding assigned cases.
Work with payors to resolve discrepancies and document outcomes.
Extract and analyze claims data, identifying trends, patterns, and anomalies.
Conduct root cause analysis on claims cost drivers and utilization patterns.
Build and maintain Excel models for claims forecasting and trend analysis using pivot tables and advanced formulas.
Perform financial reconciliation and validate claims processing accuracy.
Prepare and maintain reporting on open/closed claims, reconciliation status, outstanding risks, and KPIs, flagging significant deviations.
Identify recurring issues, cost-saving opportunities, and recommend process improvements.