Department: Claims Processing
Reports To: Claims Manager
Employment Status: Full-Time
Compensation: $50,000 – $70,000 per year, depending on experience and location
Position Overview :
The Claims Analyst is a critical member of the Claims Processing Department, responsible for reviewing, analyzing, and processing insurance claims. This role plays a key part in ensuring the timely and accurate settlement of claims, providing essential support to policyholders.
Key Responsibilities :
- Review incoming insurance claims for completeness and accuracy.
- Analyze claims to determine the extent of the insurance company’s liability.
- Interact with policyholders, agents, and adjusters to obtain necessary documentation and information.
- Calculate benefits payable and approve or deny claims based on the company’s policies and guidelines.
- Work closely with the legal team in cases involving contested or complex claims.
- Generate reports to track claims status, financial impact, and other key metrics.
- Participate in audits and compliance checks as required.
Qualifications :
- Bachelor’s degree in Business, Finance, or a related field.
- Minimum of 2-4 years of experience in insurance claims or a similar analytical role.
- Strong analytical, mathematical, and problem-solving skills.
- Excellent verbal and written communication skills.
- Proficiency in Microsoft Office Suite, especially Excel, and familiarity with claims software.
Benefits :
- Comprehensive healthcare package, including medical, dental, and vision.
- 401(k) retirement plan with company match.
- Generous paid time off (PTO) and holidays.
- Opportunity for performance bonuses and career advancement.
This job description provides a comprehensive outline of the responsibilities, qualifications, and compensation for the Claims Analyst role. Please note that the compensation range is a general estimate and may vary depending on the company’s size, location, and financial standing.