Claims Analyst – Remote/Hybrid Possibility – Lucent Health Solutions LLC – Appleton, WI

Claims Analyst Job Description – Remote/Hybrid Possibility

Role Summary

Our Claims Analyst process medical, dental, disability, pharmacy, and flexible spending claims. In addition, they certify the check run process in a timely and accurately manner The analyst also provides exceptional customer service and claim resolution for their assigned groups, and members and check run process in a timely and accurately manner.

Daily role responsibilities:

• Process medical and/or dental claims, as well as disability, pharmacy, flexible spending, or vision claims, if applicable.
• Interpret and apply specific plan document language as well as determine eligibility for benefits during claims adjudication.
• Works collaboratively with claims administration, client services, account management and check run for Lucent Health client groups.
• Provide written correspondence and verbal information to members, external and internal group contacts, agents, and healthcare providers.
• Refer potential abuse, subrogation, and adjustment claims.
• Perform necessary check run process and communicate check register information.
• Maintain a positive and professional attitude.
• Meet quality and production requirements and adhere to expectations determined by the claims department.
• Remote/Hybrid Possibility.

This position could be a good fit if you have:

• High School Diploma / GED (or higher)
• Strong analytical skill set: must have the ability to identify and solve discrepancies.
• Ability to navigate through and utilize 25+ PC applications efficiently.
• Strong organizational skills, problem solving, and decision-making skills required.
• Self-directed and starter skills required.
• 1+ years of experience in a related environment, claims processing, medical coding, or billing preferred.
• Working hours: 8:00AM to 5:00PM M-Th, Friday 8:00AM to 4:00PM.
• Demonstrated written and oral communication skills required.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Physical and Emotional Demands:

While performing the duties of this job, the employee is frequently required to sit. The employee is regularly required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms; climb or balance; stoop, kneel, and talk or hear. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus.

Equal Employment Opportunity Policy Statement

Lucent Health Solutions, Inc. is an Equal Opportunity Employer.