Transforming the health of the communities we serve, one person at a time.
Lead Claims Analyst
Location
Missouri
Posted
5 days ago
Salary
$23 - $39 / hour
Seniority
Senior
Job Description
Job Requirements
- High school diploma or equivalent
- Associate degree or equivalent experience preferred
- 2+ years of claims processing required
- Experience with Medicaid, Marketplace, or Medicare claims required
- Experience using computers and advanced skills in Microsoft Office (Word, Excel, etc.) required
- Ability to perform math functions and reason logically
- Knowledge of ICD-9/10, CPT, HCPCs, revenue codes, and medical terminology required
- Must have successfully completed claims basic training, COB advanced training, and ramp period.
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Related Guides
Related Categories
Related Job Pages
More Claims Specialist Jobs
Claims Specialist - Medical Professional Liability
ProAssuranceWe are committed to providing a dynamic and inclusive environment where everyone can do their best work and grow personally and professionally. For that reason, we partner with The Predictive Index (PI) – an organization equally committed to improving the working lives of people, to help us hire the best talent by providing additional insight about one’s work style. The position you applied to requires completion of two assessments prior to being scheduled to interview with a hiring manager. A Talent Acquisition team member may review your application and contact you before the assessment is complete. These assessments are Behavioral and Cognitive (internal candidates will only receive the Behavioral assessment), and each assessment takes less than 12 minutes to complete. After submitting your application, you will receive two emails from The Predictive Index inviting you to complete each of these assessments (please check your SPAM or Junk email folder if you do not see these emails in your inbox). Position Salary Range: $76,208.00 - $125,756.00. The salary range displayed represents the entirety of the pay grade for this position. Most candidates will start in the bottom half of the range. Factors that may be used to determine your actual salary include your specific skills, how many years of experience you have, your location and comparison to other team members already in this role.
The primary responsibility involves providing direction and guidance throughout the life of a claim, including investigation, coverage analysis, monitoring defense counsel, controlling legal expenses, and reserving. Specialists will also participate in review processes to evaluate liability, case value, and reserving functions to manage total claims cost.
The General Adjuster investigates claims for personal, casualty, or property loss or damages, handling complex local losses unassisted and assisting on larger ones, including accounting-based losses. Responsibilities include examining coverage, interviewing parties, inspecting damage, estimating costs, preparing findings reports, negotiating settlements, and recommending litigation when necessary.
Claim Specialist II or III-NJ and PA
MEMICCompassion, trusted partnerships, and relentless commitment to workforce safety
The Claim Specialist is responsible for investigating, evaluating, negotiating, and resolving medical-only and lost time workers' compensation claims within established authority limits for NJ and PA jurisdictions. This role also involves administering benefits, coordinating managed care, and interacting with regulatory bodies to ensure compliance.
CA - Senior Claims Adjuster, Workers Compensation
Pie InsurancePie is transforming small business insurance. Our team of seasoned technology and insurance experts are on a mission to empower small businesses to thrive by making insurance affordable and as easy as pie.
The Senior Claims Adjuster handles all aspects of workers' compensation claims, ensuring compliance with regulations, managing high-exposure claims, and providing excellent customer service.
