Claims Specialist - LHB

At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Required Job Qualifications:

• 4 years medical claims processing experience.
• Must possess and apply a comprehensive knowledge of specialized medical claims processing, an understanding of code review edits as well as fraud and abuse patterns.
• Ability to provide excellent communication in verbal and written form. Excellent interpersonal skills.
• Performance and audit scores of 99% payment, 97% financial and 97% accuracy (or better).
• Familiarity with various PPO reimbursement methodologies.
• Possess a basic knowledge/understanding of stop loss coverage.
• Computer proficiency in Microsoft Office programs.
• Exceptional organization skills.
• Extremely detail oriented.
• Ability to work effectively with team members, employees, providers, and clients.
• Ability to work in a fast-paced, customer service driven environment.
• Supervisor work ethic.

Preferred Job Qualifications:

• Employment with HB as a Medical Claims Analyst and then Sr. Claims Analyst preferred.

This is a Telecommute (Remote) role. Candidates must live within the following states: IL, IN, IA, KS, MO, MT, NM, NC, OK, PA, TN, TX or WI

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

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.

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 forassociates.

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

Min to Max Range: