Senior Claims Analyst

Elevance Health • Nashville, TN

9d • Remote

About The Position

JR188434 Senior Claims Analyst CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services. CareBridge is seeking a Senior Claims Analyst professional to support reporting, analytics, and process improvements across the claim’s lifecycle. In this role, you’ll use your claims expertise and SQL/data skills to turn complex data into actionable insights, support claim corrections, and improve workflows. You’ll build reporting solutions, enhance submission performance, and partner with Product, Engineering, Finance, and Operations to improve and scale end-to-end claims processes. Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. How you will make an impact:

Requirements

• Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 6 years systems analyst or business analyst experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• 5+ years of experience in provider-side claims, revenue cycle, or data management.
• Strong understanding of professional claim formats (837P), remittance advice (835), and clearinghouse workflows.
• Advanced SQL skills with experience querying complex healthcare production or analytics databases.
• Hands-on experience within a claims platform, including claim correction, resubmission, and configuration validation.
• Experience developing reports and dashboards using BI tools (e.g., Tableau, Power BI, Metabase)
• Ability to translate complex data into clear, actionable insights for business stakeholders.
• Strong cross-functional communication skills with experience partnering across Product, Engineering, Finance, and Operations.
• Experience working in value-based care environments.

Responsibilities

• Claims & Encounter Reporting Build and maintain reporting to track the full claims lifecycle from submission to payer response.
• Create self-service tools for Operations, Finance, and Client Success.
• Reconcile data across systems to ensure accurate claim status tracking.
• Claims Subject Matter Expertise Act as an SME on claims structure, clearinghouse workflows, and payer responses.
• Support complex claim issues and partner with Product and Engineering to resolve data/workflow gaps and validate fixes.
• Payer Configuration & Onboarding Support new payer implementations, including workflow setup and validation.
• Develop standardized monitoring for go-lives and streamline payer-specific processes.
• Process Improvement & Operations Identify and resolve recurring submission issues.
• Partner cross-functionally to improve workflows, tools, and documentation.
• Support audits and quality reviews.

Benefits

• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees