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Claims Analyst - LHB

Role overview

Summary

This role focuses on examining and analyzing claims to ensure accuracy and compliance within Luminare Health. You will work in a collaborative environment, engaging with team members and clients to support the claims process and contribute to the overall efficiency of healthcare services.

Qualifications

  • High School diploma or GED equivalent.
  • Effective verbal and written communication skills.
  • Ability to work in a fast-paced, customer-centric environment.
  • Strong math and decision-making skills.
  • Self-motivated with high learning agility.

Responsibilities

  • Examine and analyze claims for accuracy and compliance.
  • Communicate effectively with team members, clients, and providers.
  • Utilize MS Excel and Word to manage data and documentation.
  • Adapt to various system platforms and learn new proprietary systems.

Key facts

Hard skills

Other skills

  • Analytical Skills
  • Detail Oriented
  • Decision Making
  • Customer Service
  • Non-Verbal Communication
  • Teamwork
  • Time Management
  • Microsoft Excel
  • Microsoft Word
  • Microsoft Outlook
  • Adaptability
  • Learning Agility

About the company

Luminare Health logo

Luminare Health

  • Health Insurance & Payers
  • 1,001–5,000
Luminare Health is a total benefits solution that helps self-funded employers manage their healthcare costs, supports clients’ strategic growth goals through white-labeled back-office services, and empowers members to live their healthiest lives. Luminare Health, is standalone operating subsidiary of Health Care Services Corporation with clients across the United States.

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Job description

At Luminare Health, our people are what set us apart. Their expertise, dedication, and passion for service excellence are the foundation of our success.


We're committed to helping our employees grow through thoughtful development opportunities, meaningful work, and a culture that values collaboration and continuous improvement. When you join Luminare Health, you join a purpose-driven team focused on making healthcare simpler, better, and more affordable.

Job Summary

NA

CLAIMS ANALYST

Required Job Qualifications:

  • High School diploma or GED equivalent
  • Ability to work in a fast-paced, customer centric and production driven environment
  • Effective verbal and written communication skills
  • Ability to work effectively with team members, employees/members, providers, and clients
  • Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form
  • Flexible; open to continued process improvement
  • Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word

Preferred Job Qualifications:

  • 1 year Health Insurance experience
  • Self-Funded Insurance/Benefits and/or TPA experience
  • Knowledge of medical procedure and diagnosis coding
  • Knowledge of medical terminology
  • Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools

LIFE & DISABILITY - CLAIMS ANALYST

Required Job Qualifications:

  • An understanding of claims examining; solid investigation, analytical and organizational skills, and attention to detail.  
  • Must have strong math and decision-making skills.
  • Must be able to work in a deadline driven, fast-paced environment.
  • Self-motivated with high learning agility.
  • Must have excellent verbal and written communication skills with a passion for helping others.
  • Must be a self-starter with strong time management skills to prioritize workload, manage and follow-up on numerous tasks.    
  • Capable of making decisions in the absence of specific directions with minimal supervision.
  • Ability to effectively cope with change and shift gears accordingly in a dynamic environment. 
  • Must display a strong commitment to teamwork and have the ability to work in a collaborative environment.
  • Effective in the use of personal computers and related software.  Proficiency in working with Word, Excel and Outlook.
  • High School diploma or GED equivalent

Preferred Job Qualifications:

  • Four-year college degree in medical and/or business field.
  • Life and/or Disability claim knowledge.
  • Knowledge of medical terminology.
  • Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools.
  • Proficiency in working with Microsoft Access.

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

EEO Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Pay Transparency Statement:

At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates. 

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Min to Max Range:

$14.97 - $28.12

Exact compensation may vary based on skills, experience, and location.

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