Claims Analyst III

Posted 4 Days Ago
Be an Early Applicant
Hiring Remotely in USA
Remote or Hybrid
61K-80K Annually
Senior level
Healthtech • Social Impact • Transportation • Telehealth
Our complementary healthcare technologies and services connect the underserved more equitably with care.
The Role
Reviews and processes claims for accuracy, completeness, eligibility, payment, and irregularities. Investigates account discrepancies, resolves invoice disputes, requests missing information, and monitors claims systems. Develops solutions to claims issues, supports system enhancements, and handles complex cases. Provides leadership, coaching, and mentoring to junior team members while maintaining accurate data entry and customer-focused communication.
Summary Generated by Built In

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 positions 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.


You will...
  • 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 excited to speak to someone with...
  • 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-$80,000


The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of the position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job.


Primarily seated work; extensive computer and telephone use; occasional standing, walking, reaching, bending, and lifting up to 10 lbs. 

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 [email protected]

Skills Required

  • Bachelor's degree
  • Five or more years of experience, or equivalent combination of education and experience
  • Strong understanding of claims processing and ability to determine claim eligibility
  • Attention to detail and proficient data entry skills
  • Intermediate proficiency with Microsoft Word, Excel, and Outlook
  • Analytical ability to interpret claim data and follow established guidelines
  • Excellent verbal and written communication skills
  • Problem-solving ability to resolve claim issues and discrepancies
  • Ability to work independently and collaboratively
  • Typing speed of at least 35 words per minute and 10-key proficiency
Am I A Good Fit?
beta
Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.

The Company
HQ: Denver, CO
28,000 Employees
Year Founded: 1996

What We Do

Modivcare is leading the transformation to better connect people with care, wherever they are. We serve the most underserved by facilitating non-emergency medical transportation, monitoring, and personal and home care to enable greater access to care, reduce costs, and improve outcomes. We believe social and economic factors such as where you live, work or learn should never be a barrier to care. These factors, known as the social determinants of health, lead to inequities in our healthcare system and it’s our mission to close that gap by making connections to care. To make a world of difference, one member at a time. That’s what drives us.

Why Work With Us

We work with a range of clients: public and private payers, health systems, hospitals and universities. All united in purpose to better connect people with care. If you want your work to positively impact the lives of others, we want to hear from you.

Gallery

Gallery

Similar Jobs

T-Mobile Logo T-Mobile

Account Executive

Other • Utilities
Remote
Oklahoma, USA
89016 Employees
43K-78K Annually

T-Mobile Logo T-Mobile

Account Executive

Other • Utilities
Remote
Florida, USA
89016 Employees
43K-78K Annually

T-Mobile Logo T-Mobile

Account Executive

Other • Utilities
In-Office or Remote
2 Locations
89016 Employees
43K-78K Annually

Similar Companies Hiring

OneImaging Thumbnail
Healthtech
Miami, FL
62 Employees
Vitalize Thumbnail
Artificial Intelligence • Healthtech • Software
US
50 Employees
Vega Thumbnail
Artificial Intelligence • Automotive • Insurance • Transportation
US
65 Employees

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account