<div class="benefits">
<div><strong>Benefits:</strong></div>
<ul>
<li>401(k)</li>
<li>401(k) matching</li>
<li>Dental insurance</li>
<li>Health insurance</li>
<li>Vision insurance</li>
<li>Wellness resources</li>
</ul>
</div>
<div class="trix-content">
<div>
<strong>Summary<br></strong><br>
</div><div>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.<br><br>
</div><div><br></div><div>
<strong>Duties and Responsibilities<br></strong><br>
</div><div>· Analyze claims data and prepare ad-hoc and routine reports to support quality improvement and operational decision-making.<br><br>
</div><div>· Analyze trends in claim denials, payment discrepancies, and provider performance to identify process improvement opportunities<br><br>
</div><div>· Identify payment variances, system issues, and process gaps; recommend corrective actions.<br><br>
</div><div>· Collaborate with the Claims Management team and provide strategic feedback to the Director of Claims.<br><br>
</div><div>· Communicate effectively with internal departments, external vendors, consultants, and partner organizations.<br><br>
</div><div>· Develop and maintain dashboards, reports, and KPIs to measure claims accuracy, timeliness, and financial impact<br><br>
</div><div>· Assist in planning and facilitating team meetings and workflow improvement sessions.<br><br>
</div><div>· Identify operational and project risks; develop mitigation strategies and escalate critical concerns as needed.<br><br>
</div><div>· Provide technical assistance and training to staff regarding claims systems, workflows, and enhancements.<br><br>
</div><div>· Maintain compliance with organizational policies and procedures.<br><br>
</div><div>· Demonstrate and uphold the organization’s core values: Accountability, Community, Celebration, Integrity, Innovation, and Collaboration.<br><br>
</div><div><br></div><div>
<strong>Minimum Job Requirements<br></strong><br>
</div><div>· Bachelor’s degree.<br><br>
</div><div>· Experience in Claims and Managed Care<br><br>
</div><div>· Experience in data analytics<br><br>
</div><div>· Strong organizational and mathematical skills. The ability to work independently and adhere to deadlines<br><br>
</div><div><br></div><div>
<strong>Skill and Abilities<br></strong><br>
</div><div>· Excel and analytic experience<br><br>
</div><div>· Strong organizational and mathematical skills<br><br>
</div><div>· Must be detail oriented, able to work independently and multitask.<br><br>
</div><div>· The ability to work independently and adhere to deadlines</div>
</div>
<p>This is a remote position.</p>