- Support team discussions, aid in team claims issue resolution efficiently, and lead by example.
- Accurately review, investigate and confirm coverage to appropriately process medical claims and identify key components of processing requirements based on contracts, policies and procedures
- Support team in testing claims and system configurations.
- Play a key role in helping develop team members to perform at their highest level by offering coaching opportunities, sharing expertise and best practices, offering on the spot feedback and celebrating achievements.
- Examine and confirm coverage to appropriately process medical claims and identify key components of processing requirements based on contracts, policies and procedures.
- Review claims queues and provide expertise to address nuances with appropriate parties.
- Assist with periodic claims and process auditing to improve department outcomes.
- Continually meet department metrics and qualityset forth by leadership.
- Play a key role in the development of departmental workflows and procedures.
- Facilitate the department specific training and continuation of education training.
- Collaborate with QA team to determine necessary updates to department processes and procedures to improve departmental quality and efficiency.
- Work with leadership to monitor and report on KPI data.
- Communicate complex claims issues clearly through documentation and direct communications.
- Ability to utilize multiple applications to fulfill all job functions.
- High School Diploma
- 5 + years of experience processing/adjusting and/or analyzing medical claims preferably in a TPA environment.
- Strong knowledge of CPT/HCPC and ICD-10 code rules.
- Previous experience using Javelina processing system.
- Ability to set priorities, manage time and work independently.
- Basic proficiency using Windows based other computer applications.
- Functional comfort with Zoom, Microsoft Teams, or Google Meets
- General knowledge of CMS claims submission regulations
- Demonstrated success getting results through collaboration.
- Excellent facilitation and transferable knowledge skills communicating effectively on complex concepts.
- Proven ability to develop and implement medical claims processes.
- Experience in managing and assigning claims inventory.
- Medical Coding experience/certification
- Medical Billing experience
- Understanding of provider data
- Previous start-up company experience
- Degree in Healthcare Administration or similar field
- Training and ability to create processes/procedure documentation is a plus.
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Claims Analyst
1 week ago
(IRET) Investors Real Estate Trust Minneapolis, United StatesCorporate Support Office - Minneapolis · Minneapolis, MN 55402, USA · Description · Claims Analyst · Minneapolis, MN · Summary · The Claims Analyst position supports the reporting and management of the incident management program and drives improved performance on claims costs ...
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Marsh McLennan Companies Edina, United States Full timeDescription: · We are seeking a Reinsurance/Accounting or Claims Business Analyst in our Edina, MN or New York, NY offices. · Guy Carpenter is the world's premier reinsurance intermediary and strategic advisor to leading insurance and reinsurance organizations, delivering integr ...
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Guy Carpenter Edina, United States OTHERWe are seeking a Reinsurance/Accounting or Claims Business Analyst in our Edina, MN or New York, NY offices. · Guy Carpenter is the world's premier reinsurance intermediary and strategic advisor to leading insurance and reinsurance organizations, delivering integrated solutions t ...
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Marsh & McLennan Companies Hopkins, United StatesCompany:Guy CarpenterDescription:We are seeking a Reinsurance/Accounting or Claims Business Analyst in our Edina, MN or New York, NY offices.Guy Carpenter is the world's premier reinsurance intermediary and strategic advisor to leading insurance and reinsurance organizations, del ...
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Marsh & McLennan Companies Hopkins, United StatesCompany: · Guy Carpenter · Description: · We are seeking a Reinsurance/Accounting or Claims Business Analyst in our Edina, MN or New York, NY offices. · Guy Carpenter is the world's premier reinsurance intermediary and strategic advisor to leading insurance and reinsurance or ...
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Travelers Insurance Saint Paul, United States OTHERWho Are We? · Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture ...
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Risk Manager
1 week ago
Kraemer North America Plain, United StatesKraemer North America is currently looking for a corporate **Risk Manager** to join our team (based out of our Upper Midwest Wisconsin/Illinois/Iowa Region). The Risk Manager is a hands-on position responsible for managing the overall risk management process for the company and i ...
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Configuration Analyst
1 week ago
UCare Minnesota Minneapolis, United StatesABOUT UCARE · UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and co ...
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Business Analyst
3 days ago
Randstad North America, Inc. Minneapolis, United States. Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems. · . Support automation, special projects and rework claim inquiries that come into the Plan. · . Ide Business Analyst, Data Analyst, Analyst ...
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Lead Health Information Data Analyst
2 weeks ago
Ebenezer Senior Living Minneapolis, United StatesLeads discussions with care teams and leadership to craft analytic reports using electronic medical record data, claims, and other data sources. Mentors other analysts in the principles and technologies used by the Data Reporting and Analytics organi Data Analyst, Information, He ...
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Attorney - with JD Degree (31526)
4 days ago
Myticas Consulting Minneapolis, United StatesMyticas's direct client based out of Minneapolis, MN is currently seeking an Attorney for a 100% Remote contract position. · NOTE: W2 only · Job Description: · As part of our quality assurance process, the QA Analyst will conduct an expert peer review of LBACOE invoice analysts' ...
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Attorney/Legal Invoice Analyst
1 week ago
Myticas Consulting Minneapolis, United StatesMyticas's direct client based out of Minneapolis, MN is currently seeking a Attorney/Legal Invoice Analyst for an 100% Remote contract position. · NOTE: W2 only · Job Description: · As part of our quality assurance process, the QA Analyst will conduct an expert peer review of LBA ...
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Attorney/Legal Invoice Analyst
1 week ago
Myticas Consulting Minneapolis, United StatesMyticas's direct client based out of Minneapolis, MN is currently seeking a Attorney/Legal Invoice Analyst for an 100% Remote contract position. · NOTE: W2 only · Job Description: · As part of our quality assurance process, the QA Analyst will conduct an expert peer review of ...
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Configuration Analyst
2 days ago
UCare Minnesota Minneapolis, United StatesABOUT UCARE · UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and c ...
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Sr. Business Analyst
1 week ago
ITR Group Minneapolis, United StatesContract to potential hire opportunity for a Senior Business Analyst with extensive experience in Life Insurance and Annuities industry. This role can be fully remote (based in the US) or hybrid option if local to Minneaoplis, MN area. · Client requirements: · -Must be W2 hourl ...
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Claims Field Adjuster
1 week ago
Munich Re Minneapolis, United States**Claims Field Adjuster - Minneapolis MN Remote** · ** WE OFFER** · If you're looking for a rewarding career in a growing company with a true career path, it's time to claim your future with the American Modern claims department. You'll be working on the frontlines of our busin ...
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Logistics Analyst
1 week ago
Apex Systems Minneapolis, United StatesApex Systems is looking for a Logistics Analyst to assist our client in the medical device industry located in Minneapolis, MN. This role would provide a unique opportunity to sharpen skills in freight auditing by working alongside industry professionals with an established compa ...
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Epic Prelude Cadence Trainer/Analyst
1 week ago
Hennepin County Minneapolis, United StatesThe Hennepin County Public Health Finance area is seeking an Epic Prelude Cadence Trainer/Analyst. This position will provide ongoing system evaluation and maintenance to ensure optimal performance and utilization of Epic applications. The ideal candidate will have a firm grasp o ...
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Sr. Business Analyst
5 days ago
ITR Group Minneapolis, United StatesContract to potential hire opportunity for a Senior Business Analyst with extensive experience in Life Insurance and Annuities industry. This role can be fully remote (based in the US) or hybrid option if local to Minneaoplis, MN area. · Client requirements: · -Must be W2 hourly ...
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Data Analyst
2 weeks ago
Vision It US Minneapolis, United StatesJob Description · Job Description · 100% telecommute. EST time zone work hours · Interview Process: 2 rounds via video · ****These positions require SNOWFLAKE (DWH) , ADF and Shall be very good at SQL,PLSQL and UNIX**** · Skills: · 1-2 years of Snowflake · 1-2 years of Python ...
Senior Claims Analyst - Minneapolis, United States - Gravie
Description
Hi, we're Gravie.Our mission is to improve the way people purchase and access healthcare through innovative,consumer-centric health benefit solutions that people can actually use.
Our industry-changing products and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.As Gravie looks to continue its member-centric approach to healthcare, the
Senior Claims Analyst
will support, review and adjudicate claims in our best in class claim system.
The Senior Claims Analyst will be a subject matter expert capable of thoroughly evaluating, researching, and analyzing claim submissions with a solid knowledge of national claims guidelines.
In addition to personally reviewing complex claims, the Senior Claims Analyst will play a key role in elevating the performance of the team, assisting in training, serving as a resource to other Examiners, and pitching in as needed with special projects.
The Senior Claims Analyst will also support leadership with inventory management, process development, auditing, and other tasks as assigned.You will:
You bring:
Extra credit:
In addition to standard benefits, Gravie's package includes alternative medicine coverage, flexible PTO, 16 weeks paid parental leave, paid holidays, cell phone reimbursement, education reimbursement, and 1 week of paid paw-ternity leave just to name a few.
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Senior Claims Analyst professionals in Minneapolis
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Kyle Kramer
Actuarial Analyst
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Claudia Savelli
Delivering Superior Customer experience