Claims Analyst III
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Claims Analyst III auditing claims, resolving payment discrepancies, and improving claims systems for Modivcare. Providing complex issue resolution, analysis, and junior-team mentoring.
Responsibilities:
- Implement claims processes to maximize effectiveness and accuracy
- Audit the accuracy of claims information entered in the system
- Monitor the operation of claims systems
- Develop solutions to claims issues and work with systems design to implement new features
- Review claims for irregularities, accuracy, and completeness
- Request additional information when necessary for claim processing
- Coordinate and process documentation, invoice dispute resolution, and payment for accounts
- Perform account analysis and research payment and account discrepancies
- Identify and verify transactions and expedite resolution of claims issues
- Handle complex issues and refer only the most complex issues to higher-level staff
- Provide leadership, coaching, and/or mentoring to more junior team members
- Participate in other projects or duties as assigned
Requirements:
- Bachelor's Degree required, or equivalent combination of education and/or experience
- Five (5) plus years of 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
Benefits:
- 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!)
Similar Jobs
Claims Specialist
Claims Specialist resolving pended medical claims for Arkansas Blue Cross and Blue Shield. Investigating benefits, eligibility, coding, audits, and processing issues remotely.
Claims Specialist I – Provider Claims
Claims Specialist evaluating and resolving provider medical claims for Inland Empire Health Plan. Determining coverage, payments, disputes, appeals, and adjustments.
Claims Representative
Remote claims representative helping homeowners secure maximum insurance settlements for property damage. Conducting inspections, interpreting policies, serving clients, and completing claims paperwork.
Claims Representative
Claims representative reviewing insurance policies, inspecting properties, and initiating claims for a major U.S. adjustment firm. Flexible remote or in-person schedule with training and advancement opportunities.
Field Property Claims Adjuster
Field Property Claims Adjuster inspecting policyholder properties across the Eugene area for Farmers Insurance. Assessing damage, writing estimates, and negotiating fair settlements.
Field Property Claims Adjuster
Field property claims adjuster assessing residential damage, liability, and losses for Farmers Insurance. Conducting investigations and negotiating settlements across the Greater Columbia area.
Claims Adjuster
Remote contract Claims Adjuster guiding US property-insurance customers through claim resolution. Investigating losses, applying coverage, issuing payments, and writing accurate exterior estimates.
Professional Liability Claims Examiner III
Professional Liability Claims Examiner managing complex claims for an insurance organization. Reviewing coverage, investigating liability, and guiding reserves and settlements through resolution.
Professional Liability Claims Examiner, III
Professional Liability Claims Examiner III managing complex claims for an insurance organization. Reviewing coverage, investigating liability, and directing claims through resolution.
Claims Specialist II
Remote Claims Specialist II guiding Mercury Insurance customers through vehicle, property, and moderate bodily injury claims. Investigating liability, negotiating settlements, and delivering high-quality service.
Material Damage Claims Specialist
Material Damage Claims Specialist completing automobile damage estimates, appraisals, and valuations for REPO Plus. Auditing claims and training adjusters across US operations.
Liability Claims Specialist
Remote Liability Claims Specialist managing medical-only and minor lost-time liability claims for CorVel, a risk management solutions provider. Evaluating coverage, compensability, reserves, payments, and claim status.
Claims Analyst – Temp
Claims Analyst settling cargo claims for Sirva’s relocation and transportation services. Investigating liability, negotiating settlements, and coordinating damage assessments for US and Canadian customers.
Claims Associate Adjuster – PIP
PIP claims associate supporting adjusters with medical billing, documentation, payments, and claim processing. Amerisure serves commercial construction, manufacturing, and healthcare businesses.
Claims Examiner
Remote Claims Examiner reviewing and processing healthcare claims for Blue Cross and Blue Shield of Kansas. Ensuring accurate coding, coverage decisions, compliance, and timely resolution.
Financial Claims Associate
Financial Claims Associate analyzing health-plan claims expenses, invoicing, and stop-loss coverage for Blue Cross NC. Supporting forecasts, reconciliations, audits, and employer-group reporting.
Senior Environmental, Construction Defect Claims Specialist
Senior claims specialist managing complex environmental, toxic tort, and construction defect claims for Amerisure, a commercial property and casualty insurer. Evaluating coverage, liability, damages, reserves, and settlements across jurisdictions.
Senior Claims Specialist, Commercial Casualty
Senior commercial casualty claims specialist resolving personal and commercial injury claims for Mobilitas, a mobility-sector insurer. Handling nationwide coverage, liability, investigation, negotiation and subrogation.
Complex Casualty Claims Specialist
Complex casualty claims specialist managing severe casualty litigation, investigations, reserves and settlements for EMC. Providing technical claims expertise while collaborating with counsel, underwriting and recovery teams nationwide.
Marine Claims Adjuster
Remote Marine Claims Adjuster handling inland marine property and liability claims. Investigating, evaluating, negotiating, and resolving commercial and personal insurance losses.