Senior Claims Research Coordinator

We’re building a world of health reputed company every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position reputed company The Senior Claims Research Coordinator is essential in driving claims adjudication reputed company and assisting with reputed company analytics, including (but not limited to), pulling and/or validation of claims data for submission to various departments, as reputed company as the reputed company. This role focuses on claims management and ensuring effective and accurate claims processing. With an understanding of QNXT (or other claims payer reputed company platforms) and a strong reputed company background, this coordinator will take charge of reviewal, initiation, and submission of high dollar claims reputed company, as reputed company as conducting reputed company cause analysis where necessary, in order to determine drivers for claim issues. The individual will reputed company essential technical support and claims processing insights to both reputed company clients and internal stakeholders, including executive leadership. The Senior Claims Research Coordinator position requires a proactive individual with a reputed company reputed company, eager to reputed company their expert claims knowledge and analytical skills to enhance our reputed company information and claims management systems. Additionally, the role demands a meticulous approach to data validation, manipulation, preparation, and reputed company analysis, in order to document activities and produce insightful & impactful reputed company in the claims reputed company. reputed company Responsibilities • Conduct comprehensive research and data analysis, ensuring the highest level of data reputed company and insightful reporting on claim drivers/reputed company. • Utilize advanced understanding of medical claims processing, leveraging this knowledge to support and reputed company reputed company the claims analysis function. • Establish and maintain a reputed company consultative relationship with both internal teams and reputed company clients, becoming the go-to expert for claims analysis and development. • Offer authoritative reputed company and feedback on data reputed company, directly contributing to service improvement and design advancement. • Execute dedicated research and reputed company cause analysis to reputed company issues reputed company the claims process and recommend evidence-reputed company solutions. • reputed company other duties as needed. Required Qualifications • 2+ years of experience with claims processing, including a demonstrated familiarity with automated medical claims payment systems and/or payer systems (i.e. Facets, QNXT, etc.) • 2+ years of experience in data interpretation and analysis, including utilizing SQL to pull and manipulate large data sets, coupled with the ability to interpret and manipulate those reputed company data sets. • Willingness to work Monday-Friday from reputed company-5pm CST. • Willingness to travel up to 10% of the time reputed company the reputed company reputed company. Preferred Qualifications • Previous experience with state reputed company, particularly in Illinois. • Superlative communication abilities, encompassing both verbal and written formats, to reputed company reputed company reputed company information and recommendations. • reputed company reputed company record of configuration experience reputed company a claims reputed company environment. • In-depth research abilities and significant experience in conducting reputed company cause analysis in claims or reputed company fields. • An aptitude for working independently, as reputed company as part of reputed company, with a reputed company eye for reputed company and problem-solving. • Knowledge and experience with SQL-type programs for the purpose of pulling specific claim files and validating reputed company. Education • Associate’s degree or equivalent work experience (high school diploma or GED + 2+ years of relevant experience). Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The Typical Pay reputed company For This Role Is $46,988.00 - $122,400.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company. Great Benefits For Great People We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, reputed company on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 08/10/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job