Business Systems Analysis Analyst

End-to-End Claim Management: Handle every aspect of the claim process, from intake to final decision. Status Updates: Provide frequent updates to claimants through their preferred communication channels. Document Review: Thoroughly review medical documents, claim forms, and policy notes. Communication: Interact with claimants with empathy and attention to detail. Team Collaboration: Work with team members to ensure high-quality service and resolution of issues. Record Keeping: Maintain accurate records and reports throughout the claims process. Data Analysis: Compile and analyze data to identify trends and perform root cause analysis. Designated quiet area for completing calls. Claim Initiation: Gather information and initiate claims through various channels. Detailed Logging: Log and update pertinent information throughout the claim lifecycle. Omni-Channel Correspondence: Communicate required medical records and claim information via email, mail, and phone. Proactive Follow-Up: Follow up on pending claims and assist in gathering required medical records. Benefit Calculation: Calculate benefit amounts and process payments through the claims system. Fraud Detection: Identify and flag potential fraudulent activities. Multitasking: Manage a caseload of active claims and perform end-to-end steps. Attention to Detail: Ensure accuracy and organization in logging, tracking, and reviewing claims. Collaboration: Work with management and team members to address service issues and concerns. Empathy: Communicate with claimants with empathy and a willingness to help. Management monitors all technical issues and agent downtime. 2 years in an analytical role reviewing medical benefits and claims. 2 years of claims adjudication experience, preferably in life, and supplemental products (e.g., critical illnesses such as cancer, stroke, heart attack, kidney disease). 4 years of experience reviewing and assessing medical records. Experience articulating claim requirements clearly and concisely. Education: Minimum high school diploma or GED; college degree preferred. To work remote, individuals must meet all the established Remote requirements including those pertaining to a home workspace and related technology. Technology 1. Apply tot his job Apply To this Job