The Claims Analyst III is responsible for auditing claims, ensuring accuracy in claims processing, resolving discrepancies, and providing support to junior team members. This role includes leadership responsibilities, analyzing claims data, and collaborating with systems design to enhance processing effectiveness.
Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you!
This position is responsible for implementing claims processes to maximize effectiveness and accuracy. This includes auditing the accuracy of claims information entered in the system and monitoring the operation of the claims systems. In addition, develops solutions to claims issues and works with systems design to implement new features.
This role…
- Reviews claims for irregularities, accuracy and completeness.
- Requests additional information, where necessary, for completion of claim processing.
- Coordinates and processes documentation, invoice dispute resolution and payment for accounts.
- Performs account analysis and researches payment and account discrepancies.
- Identifies and verifies transactions and expedites a resolution of various claims issues.
- Handles complex issues and problems, and refers only the most complex issues to higher-level staff.
- Possesses comprehensive knowledge of subject matter.
- Provides leadership, coaching, and/or mentoring to more junior team members.
- Participate in other projects or duties as assigned.
We are interested in speaking to individuals with the following…
- Bachelor's Degree required.
- Five (5) plus years of experience.
- Or equivalent combination of education and/or 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.
Salary: $60,800 - 82,100
Modivcare’s positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings.
We value our team members and realize the importance of benefits for you and your family.
Modivcare offers a comprehensive benefits package to include the following:
- 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!)
Modivcare is an Equal Opportunity Employer.
- EEO is The Law - click here for more information
- Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
- We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at hr.recruiting@modivcare.com
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