Senior Claims Analyst

Responsibilities

• Perform accurate adjudication and processing of medical, dental, vision, and other related claims
• Secure and analyze claim information to make life and disability benefit determinations
• Calculate benefit payments and communicate claim decisions on new and continuing claims
• Provide responsive and caring customer service to members and providers
• Advise team members regarding claim processing procedures
• Handle correspondence and electronic inquiries for assigned groups according to plan documents

Requirements

• High School diploma or GED equivalent
• 3 years of medical claim processing experience
• 3 years of life and/or disability claim administration experience
• Proficiency in MS Excel, Word, and Outlook
• Strong math and decision-making skills
• Ability to analyze and interpret Summary Plan Descriptions (SPDs)

Preferred Qualifications

• Health Insurance or Third Party Administrator experience
• Four-year college degree in medical or business field
• Understanding of medical terminology
• Proficiency in Microsoft Access

About the Company

Luminare Health, a wholly owned subsidiary of Health Care Service Corporation (HCSC), is a leading third-party administrator dedicated to making healthcare simpler, better, and more affordable for clients and their members.