[Hiring] Claims Analyst @Alight Solutions

Role Description

We are now hiring ambitious, motivated Claim Analysts to work in our team focused, premier healthcare navigation business. In this role, you will be leveraging acquired knowledge to deliver high quality customer interactions that are consultative and lead to better healthcare outcomes. Through this role, you will have the opportunity to positively impact the lives of employee customers and their families, while driving increased benefit satisfaction and reducing healthcare spend for their employers.

As a Claims Analyst, you can expect the following:

• Receive extensive health care training to ensure you are equipped to consult members on billing related issues.
• Be an advocate for members by working on their behalf with carriers, providers, and plan related documentation to resolve post-service coverage questions and/or issues in an accurate and timely manner.
• Activities include, but are not limited to the following:
• Assist in reviewing medical, dental, vision, and pharmacy related claims for accuracy to ensure members are receiving the proper benefit coverage according to plan stipulations.
• Coordinate with providers and carriers to solve billing discrepancies, coding errors, and denied claims; assist with claim resubmission, as necessary.
• Draft, submit, and exhaust appeals processes, as necessary.
• Partner directly with client to bring awareness to unique care/billing situations that may require special review.
• Coordinate with providers to determine payment plan and discount options.

Qualifications

• Bachelor’s Degree, Associate’s Degree with 2 years billing/insurance experience, or 3 years’ experience in a healthcare billing/insurance related role.
• Ability to work effectively in a remote team environment.
• Strong problem solving, reasoning, and analytical skills.
• Exceptional verbal and written communication skills – ability to articulate complex billing concepts for members that are not experts.
• Strong ability and desire to learn continually in a changing environment.
• Ability to efficiently organize work activities to meet deadlines.
• Passion to provide the highest level of client satisfaction.
• Ability to receive and immediately apply constructive feedback.
• Ability to develop effective rapport with clients based on empathy and trust.

Requirements

• Expertise and current knowledge of Medicare, Health accounts (FSA, HRA, HSA), and claims adjudication process.

Benefits

• A competitive total rewards package, starting on your first day of employment.
• Health, Dental, Vision, Life Insurance and more.
• A 401k plan that includes a corporate match.
• Paid Time Off: 10 paid holidays per calendar year (8 fixed and 2 floating), 6 paid wellness days.
• Career Development & Growth: Ongoing training, coaching and development.