Sr Claims Analyst

Responsibilities

• Adjudicate and process medical, dental, vision, and life/disability claims accurately
• Analyze claim information to make benefit determinations based on policy provisions and laws
• Calculate benefit payments and communicate decisions on new and continuing claims
• Serve as a liaison for internal departments and advise team members on processing procedures
• Provide responsive and caring customer service to members and providers

Requirements

• High School diploma or GED equivalent
• 3 years of prior medical claim processing experience
• Ability to work in a fast-paced, production-driven environment
• Strong verbal and written communication skills
• Ability to analyze and interpret Summary Plan Descriptions (SPDs)
• Proficiency with MS Excel and Word

Preferred Qualifications

• Four-year college degree in a medical or business field
• Experience with Health Insurance or Third Party Administrators (TPA)
• Understanding of medical terminology

Benefits

• Health and wellness benefits
• 401(k) savings and pension plan
• Paid time off and paid parental leave
• Disability and supplemental life insurance
• Tuition reimbursement

About the Company

Luminare Health is part of HCSC, an industry leader dedicated to expanding access to high-quality, cost-effective health care and reimagining health care delivery for Americans.