Claims Analyst

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Vision insurance
• Wellness resources

Summary The Claims Analyst is responsible for analyzing, reviewing, and improving claims processes to ensure accuracy, compliance, and operational efficiency. This role partners closely with leadership and cross-functional teams to support quality initiatives, system enhancements, and continuous process improvement. Duties and Responsibilities · Analyze claims data and prepare ad-hoc and routine reports to support quality improvement and operational decision-making. · Analyze trends in claim denials, payment discrepancies, and provider performance to identify process improvement opportunities · Identify payment variances, system issues, and process gaps; recommend corrective actions. · Collaborate with the Claims Management team and provide strategic feedback to the Director of Claims. · Communicate effectively with internal departments, external vendors, consultants, and partner organizations. · Develop and maintain dashboards, reports, and KPIs to measure claims accuracy, timeliness, and financial impact · Assist in planning and facilitating team meetings and workflow improvement sessions. · Identify operational and project risks; develop mitigation strategies and escalate critical concerns as needed. · Provide technical assistance and training to staff regarding claims systems, workflows, and enhancements. · Maintain compliance with organizational policies and procedures. · Demonstrate and uphold the organization’s core values: Accountability, Community, Celebration, Integrity, Innovation, and Collaboration. Minimum Job Requirements · Bachelor’s degree. · Experience in Claims and Managed Care · Experience in data analytics · Strong organizational and mathematical skills. The ability to work independently and adhere to deadlines Skill and Abilities · Excel and analytic experience · Strong organizational and mathematical skills · Must be detail oriented, able to work independently and multitask. · The ability to work independently and adhere to deadlines

This is a remote position.

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