Claims Analyst

Position Summary

As a Claims Analyst, you are composing, maintaining and clarifying the policies and procedures for the Claims team. Our Claims Analyst is essential to ensuring the Medicare Part D Compliance team is following CMS guidelines. The Claims Analyst is responsible for making sure the policies and procedures are simple and clear for the team to understand, and must be able to answer questions that the team may have. The Claims Analyst is responsible for processing Medicare Part D claims.

As part of the Paper Claims department you will must be able to work well within a team environment as you will be acting as a liaison to internal partners, be able to hit deadlines and be able to set priority expectations for the team to follow.

Additional responsibilities of the Claims Analyst include:

• Being able to resolve situations with policies and procedures
• Utilizing strong communications skills
• Setting your own priorities in a fast paced environment

Position Summary

As a Claims Analyst, you are composing, maintaining and clarifying the policies and procedures for the Claims team. Our Claims Analyst is essential to ensuring the Medicare Part D Compliance team is following CMS guidelines. The Claims Analyst is responsible for making sure the policies and procedures are simple and clear for the team to understand, and must be able to answer questions that the team may have. The Claims Analyst is responsible for processing Medicare Part D claims.

As part of the Paper Claims department you will must be able to work well within a team environment as you will be acting as a liaison to internal partners, be able to hit deadlines and be able to set priority expectations for the team to follow.

Additional responsibilities of the Claims Analyst include:

• Being able to resolve situations with policies and procedures
• Utilizing strong communications skills
• Setting your own priorities in a fast paced environment

Preferred Qualifications

• 2+ years of overall experience within Med D Communications
• Strong time management, experience working in a fast paced environment, be an independent thinker, and set own priorities and possess strong communication skills
• Experience working with Microsoft Office Suite products, and claim adjudication platforms
• Ability to work well within a team environment, serves as a liaison to internal partners, and execute against priorities set independently and stated by team in a timely manner
• 3+ years of background with PBM, Claims Administration/Operations, Sales/Consulting and/or Project management experience strongly preferred
• Knowledge or previous experience with Salesforce is preferred
• Knowledge of CMS Chapter 18 Guidance

Required Qualifications

2+ years of claims processing experience