Contractor Medical Claims Analyst

Responsibilities:

• Accurately process and adjust disability claims in the claim system.
• Review disability paperwork and conduct member interviews to assess dependents' ability to maintain self-sustaining employment.
• Maintain precise records of disability claims.
• Utilize strong math skills for manual claim calculations.
• Exercise sound decision-making skills in a fast-paced environment.
• Work efficiently in a remote environment.
• Proficiently use MS Excel and MS Word to manage and track claims.
• Successfully operate within multiple systems for claim processing.
• Demonstrate a strong understanding of claim analysis.
• Ensure all tasks meet auditing standards.

Requirements

• Minimum of three years of experience as a Medical Claims Analyst or in a similar role
• Proficiency in using computer programs related to the role
• Experience in handling appeals and claim administration
• Proven experience in auditing, benefit functions, and billing functions
• Knowledge of claims processing, disability claims, and medical claims is essential
• Proficiency in Microsoft Excel is required
• Strong analytical and problem-solving skills
• Excellent written and verbal communication skills
• Ability to work independently and as part of a team
• High attention to detail and accuracy
• Ability to multi-task and meet deadlines in a fast-paced environment
• Knowledge of healthcare regulations and medical terminologies
• Bachelor's degree in healthcare administration, business, or a related field is preferred