Claims Analyst III
Required skills
- claims processing
- claim eligibility
- data entry
- analytical mindset
- claim data
- established guidelines
- customer-focused demeanor
- account discrepancies
- invoice dispute resolution
- payment processing
Nice to have
- systems design
- new features
- project management
Role summary
Modivcare is seeking a Claims Analyst III responsible for implementing and auditing claims processes to ensure effectiveness and accuracy. This role involves analyzing claim information, resolving discrepancies, and developing solutions for claims issues. The analyst will also contribute to systems design for new features and provide guidance to junior team members. A Bachelor's Degree and five years of relevant experience are required, along with strong analytical, problem-solving, and data entry skills, and proficiency in Microsoft Office applications.
Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you!
This positions is responsible for implementing claims processes to maximize effectiveness and accuracy. This includes auditing the accuracy of claims information entered in the system and monitoring the operation of the claims systems. In addition develops solutions to claims issues and works with systems design to implement new features.
You will...
- Reviews claims for irregularities, accuracy and completeness.
- Requests additional information, where necessary, for completion of claim processing.
- Coordinates and processes documentation, invoice dispute resolution and payment for accounts.
- Performs account analysis and researches payment and account discrepancies.
- Identifies and verifies transactions and expedites a resolution of various claims issues.
- Handles complex issues and problems, and refers only the most complex issues to higher-level staff.
- Possesses comprehensive knowledge of subject matter.
- Provides leadership, coaching, and/or mentoring to more junior team members.
- Participate in other projects or duties as assigned.
We are excited to speak to someone with...
- Bachelor's Degree required.
- Five (5) plus years of experience.
- Or equivalent combination of education and/or experience.
- Strong understanding of claims processing and ability to make informed decisions on claim eligibility.
- Excellent attention to detail and proficient data entry skills for accurate claim processing.
- Intermediate proficiency of Microsoft applications (Word, Excel, and Outlook).
- Analytical mindset with the ability to interpret claim data and follow established guidelines.
- Excellent verbal and written communication skills to interact with superior customer-focused demeanor.
- Problem-solving abilities to address claim issues and resolve discrepancies.
- Ability to work independently and as a member of a team.
- Ability to accurately type 35 words per minute and use of 10-key.
Salary: $60,800-$80,000
The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of the position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job.
Primarily seated work; extensive computer and telephone use; occasional standing, walking, reaching, bending, and lifting up to 10 lbs.
Modivcare’s positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings.
We value our team members and realize the importance of benefits for you and your family.
Modivcare offers a comprehensive benefits package to include the following:
- Medical, Dental, and Vision insurance
- Employer Paid Basic Life Insurance and AD&D
- Voluntary Life Insurance (Employee/Spouse/Child)
- Health Care and Dependent Care Flexible Spending Accounts
- Pre-Tax and Post --Tax Commuter and Parking Benefits
- 401(k) Retirement Savings Plan with Company Match
- Paid Time Off
- Paid Parental Leave
- Short-Term and Long-Term Disability
- Tuition Reimbursement
- Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)
Modivcare is an Equal Opportunity Employer.
- EEO is The Law - click here for more information
- Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
- We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at
Originally posted on Himalayas
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