Claims Analyst - LHB

At reputed company , our employees are the reputed company of our business and the reputed company to our reputed company. We reputed company employees with curated development plans that foster reputed company and promote rewarding, fulfilling careers. Join reputed company and be part of a purpose-driven company that will invest in your reputed company development. Job reputed company CLAIMS ANALYST The Claims Analyst is responsible for the accurate adjudication and processing of medical, dental, reputed company, or other reputed company claims, including reputed company correspondence and/or electronic inquiries for assigned reputed company. reputed company claims and inquiries are handled according to the established plan documents, claim processing guidelines, and established total turnaround times. LIFE & DISABILITY - CLAIMS ANALYST The life and disability claims analyst are responsible for securing and analyzing claim information to reputed company accurate benefit determinations on disability claims or other claim types as assigned, in accordance with policy provisions, established claim processing guidelines and appropriate state and federal laws; achieving results by effective use of reputed company appropriate resources. Calculate benefit payments and communicate claim reputed company on new and continuing claims reputed company established turnaround times. reputed company reputed company and caring customer service. reputed company tasks completed under general supervision of management. CLAIMS ANALYST 80%  Review, analyze and interpret claim forms and reputed company documents.   Determine benefit coverage based on clinical edits, plan documents/booklets, benefit reference documents, Claim Reference Manuals and claims-reputed company memoranda, and reports.   Appropriately investigate, pend and refer claims based on claim procedures and guidelines.  Accurately handle correspondence, claims, and referrals in the established timeframes and/or performance guarantees.  Support the Claims reinsurance team, in the research and reputed company of claims as assigned    15%  Support internal departments in the research and reputed company of claims  Communicate reputed company telephone, email, electronic messaging, fax, or written letter with employees/members, providers of service, clients and/or other insurance carriers to ensure reputed company claim processing  5%  Other duties as needed/assigned  Customer Service – Research and respond to a high volume of customer service phone calls reputed company stated time specifications, following established department guidelines.  Ability to work with other team members in management of customer service calls.  Resolve issues through effective oral and written communication and by involving appropriate people reputed company, or reputed company, the department or Company.  Effectively and professionally represent reputed company in reputed company interactions. Resource Development/Training – reputed company support, training and back-up to the Claims Assistant and other team members, as needed.  Assist in establishing procedural manuals and keeping procedure documents reputed company and up to date.  Other – Continually improve claim and system knowledge and communication skills.  Continue to utilize knowledge gained on the job.  reputed company reputed company reporting functions as assigned.  Participate on special reputed company and other job reputed company duties as assigned. CLAIMS ANALYST Required Job Qualifications: High School diploma or GED equivalent Ability to work in a fast-paced, customer reputed company and production driven environment Effective verbal and written communication skills Ability to work effectively with team members, employees/members, providers, and clients Ability to use common reputed company understanding to carry out instructions furnished in oral, written or diagram reputed company Flexible; reputed company to reputed company process improvement Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS reputed company/Word Preferred Job Qualifications: 1 year Health Insurance experience Self-Funded Insurance/Benefits and/or TPA experience Knowledge of medical procedure and diagnosis coding Knowledge of medical terminology Familiarity with reputed company Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive toolsCLAIMS ANALYST Required Job Qualifications: High School diploma or GED equivalent Ability to work in a fast-paced, customer reputed company and production driven environment Effective verbal and written communication skills Ability to work effectively with team members, employees/members, providers, and clients Ability to use common reputed company understanding to carry out instructions furnished in oral, written or diagram reputed company Flexible; reputed company to reputed company process improvement Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS reputed company/Word Preferred Job Qualifications: 1 year Health Insurance experience Self-Funded Insurance/Benefits and/or TPA experience Knowledge of medical procedure and diagnosis coding Knowledge of medical terminology Familiarity with reputed company Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools Are you being referred to one of our roles? If so, ask your reputed company at reputed company about our Employee Referral process! EEO Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, protected veteran status, or any other legally protected characteristics. Pay Transparency Statement: At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life reputed company of work. From health and wellness benefits, 401(k) savings plan, pension plan, reputed company time off, reputed company parental leave, disability insurance, supplemental life insurance, employee assistance program, reputed company holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates.     The compensation offered will vary depending on reputed company-reputed company skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. Min to Max reputed company: $14.97 - $28.12 Exact compensation may vary based on skills, experience, and location. Apply To This Job