Claims Administrator jobs in the United States

Job Description:

Concierge Third Party Administrator is looking for a dedicated and detail-oriented Claims Analyst to join our team. As a Claims Representative, you will be responsible for reviewing, analyzing, and processing medical claims to ensure accuracy, efficiency, and timely payment. This role is essential in maintaining high standards of customer service and operational excellence within the claims department.

Responsibilities:

1. Review and assess claims to determine coverage, eligibility, and validity.

2. Analyze claim documentation, policy information, and supporting evidence to make informed decisions.

3. Process claims accurately and efficiently within established timelines and guidelines.

4. Investigate and resolve discrepancies, inquiries, and issues related to claims processing.

5. Communicate with policyholders, providers, and internal stakeholders to gather necessary information and provide claim status updates.

6. Collaborate with the claims team to identify trends, patterns, and areas for process improvement.

7. Ensure compliance with regulations and industry standards in claims handling.

8. Document all claim activities, decisions, and outcomes accurately in the claims management system.

9. Participate in training sessions and professional development opportunities to enhance claims processing skills and knowledge.

10. Provide exceptional customer service by addressing inquiries, concerns, and escalations related to claims.

Qualifications:

- Bachelor's degree preferred but not required.

- Preferred experience in claims analysis, processing, or a similar role within the insurance industry.

- Strong analytical and problem-solving skills.

- Excellent attention to detail and accuracy in claim evaluation.

- Effective communication and interpersonal abilities.

- Proficiency in claims management software and Microsoft Office applications.

- Preferred knowledge of insurance policies, coverage types, and claims processing procedures is a plus .

- Ability to work independently and collaboratively in a team environment.

Benefits:

- We pay 100% of the employee's health insurance of $300 reimbursement if you choose not to utilize.

- 3% employer contribution of yearly gross wages into 401k

- 15 days of PTO

- Remote work options available.

- Opportunities for career advancement and professional growth.

- Supportive and inclusive work culture focused on employee development.

If you are passionate about claims processing, have a knack for detail, and excel in providing top-notch customer service, we encourage you to apply for the Claims Analyst position at Concierge Third Party Administrator. Join us in delivering exceptional benefits management services and ensuring client satisfaction.

Job Type: Full-time

Pay: $20.00 - $22.00 per hour

Work setting:

• Hybrid work

Experience:

• Microsoft Office: 3 years (Preferred)
• Customer service: 2 years (Preferred)

Ability to Commute:

• Bartlesville, OK 74003 (Required)

Ability to Relocate:

• Bartlesville, OK 74003: Relocate before starting work (Preferred)

Work Location: Hybrid remote in Bartlesville, OK 74003