Claims Analyst

Summary:

This is a full-time non-exempt position that provides administrative support to the Administrators Department of Armada. Claims Analyst is responsible for the processing of all Consumer Directed Healthcare (CDH) claims. This position is also responsible for the adjudication of similar supplemental insurance products. This person will directly report to the Claims Manager for supervision purposes.

Armada Employee Standards:

• Support Armada benchmarks and meet company goals.
• Be a team player.
• Sustain a positive, enthusiastic and professional attitude at all times.
• Accommodate requests with a smile and “let me see what I can do” and “wired for service” attitude.
• Adhere to supervisor directives.
• Work required shifts (including overtime) as determined by business needs.
• Maintain a professional appearance and demeanor.
• Arrive prior to the scheduled starting time, properly dressed and prepared to work.
• Perform all duties in a timely, accurate, honest, and professional manner.

Tasks/Responsibilities:

• Claims processing for manually submitted claims, including all associated tasks and benefit eligibility verification and determining the appropriate of such claims.
• Client setup and implementation for new groups and/or new products and services. Includes client coordination, internal setup and carriers.
• Processing, entering and synchronizing participant enrollments.
• Updating contributions to CDH accounts to ensure proper funding.
• Acquiring additional claims substantiation and related tasks such as claim identification, member communication and closing of said claims.
• Update and maintain member information across all systems and databases.
• Reporting for internal and external users.
• Such other duties or tasks to assist the department of organization as the supervisor may deem necessary.

Skills/Requirements:

• Must be proficient in MS Word, Excel, and Outlook.
• Excellent verbal and written communication skills required.
• Ability to work mandatory overtime during busy periods.
• Ability to meet established carrier deadlines.
• Attention to detail and an “eye for accuracy”.
• A professional appearance and telephone manner is essential.
• Must have a good command of the English language, oral, and written.
• Must be able to work in a fast-paced environment with demonstrated ability to handle multiple tasks.
• Ability to maintain confidentially
• Needs to be receptive to and accepting guidance from others
• Ability to deal with difficult people and problems
• Able to work well in a team environment
• Able to work in a diverse group of people
• Intermediate level of proficiency in Microsoft Office programs