Individual Benefit Cashless Claim, Analyst
Core
Adjudicate medical insurance claims by assessing medical documentation, establishing loss validity, and ensuring compliance with coverage guidelines.
Role type
Individual contributor claims analyst (medical insurance)
Builds
Processed medical claims and guarantee letters
Domain
Insurance / Healthcare
Required skills
Medical documentation assessment, claims adjudication, eligibility verification, process improvement, data analysis, deadline management, shift adaptability
Preferred skills
Medical insurance/nursing/medical science/hospital background, Microsoft Office proficiency, reporting tools
Responsibilities
Adjudicate medical claims within assigned authority limits, establish proof of loss by studying medical documentation, ensure completeness of claims documents, escalate questionable claims, identify process improvement initiatives, process claims within specified turnaround time
Seniority
Mid-level, independent IC