OVERVIEW

We are seeking a detail-oriented and analytical Claims Analyst to join our team. As a Claims Analyst specializing in Accident, Critical Illness, Short-Term Disability, and Hospital Indemnity lines of business, you will be responsible for accurately assessing and processing claims related to these insurance products. Your role will involve investigating claims, verifying policy coverage, determining liability, and ensuring compliance with regulatory requirements. Strong analytical skills, attention to detail, and empathy are essential for this position as you will interact with claimants, healthcare providers, and other stakeholders to facilitate timely and fair claim settlements. This role will also be trained on processing claims related to Life Insurance Products including waiver of Premium and contestible claims.

REQUIREMENTS

• Proven clerical experience with strong organizational skills.
• Familiarity with medical terminology, medical documentation, and medical records management.
• Knowledge of insurance verification processes and financial software applications.
• Experience in medical coding (ICD coding) is highly desirable.
• Understanding of DRG, CPT coding, HCPCS, Medicare, and Workers’ compensation law is preferred.
• Strong attention to detail with the ability to manage multiple tasks efficiently.
• Excellent communication skills, both written and verbal. Join our team as a Claims Analyst where you can contribute your expertise while growing your career in a supportive environment focused on excellence in healthcare administration.
  Job Types: Full-time, Contract
  Pay: $18.00 - $22.00 per hour
  Expected hours: 40 per week

Benefits:

• 401(k)
• Health insurance
• Paid time off
• Vision insurance
• Work from home

Application Question(s):

• How many years of experience processing Health and Accident Claims do you have (must be documented in your resume).

Work Location: Remot

• Review and analyze claims for accuracy and completeness, ensuring compliance with relevant laws and regulations.
• Verify insurance information and eligibility for claims processing.
• Utilize knowledge of DRG, CPT coding, ICD-9, ICD-10, HCPCS, and medical billing practices to accurately code claims.
• Maintain organized filing systems for medical documentation and financial records.
• Collaborate with healthcare providers to obtain necessary medical records and documentation.
• Ensure adherence to Workers’ compensation law and Medicare guidelines in all claims processed.
• Utilize financial software to track claims status and generate reports as needed.
• Communicate effectively with internal teams and external stakeholders regarding claim status and resolution.