Claims Processor Analyst

Job ID Number R4951 Employment Type Full time Worksite Flexibility Remote Job Summary As a Claims Processor Analyst, you will review processed claims and inquiries to determine corrective actions, including adjusting claims. Job Description We are looking for a Claims Processor Analyst to investigate and process health insurance claims and coordinate benefits for the members of our clients health plan. This position will be a full-time, remote contract through August 2025 with possible renewal/extension. Due to our end client and project work, all candidates must be United States citizens. What Youll Do Review processed claims and inquiries to determine corrective actions, including adjusting claims as necessary Utilize enrollment, benefit, and historical claim processing information to take corrective action steps Resolve claim edits, review history records, and determine benefit eligibility for services Ensure accurate provider or practice selection for claims and verify the completeness and accuracy of claim information Meet production and quality standards consistently Participate in all required training sessions to enhance skills and knowledge Escalate issues to supervisory levels as needed Maintain precise records, including timekeeping, to ensure compliance and accuracy Undertake additional tasks as assigned or requested to support team objectives What Youll Need Required: High School Diploma/GED required Experience in healthcare insurance is essential Proficient in data entry and basic computer skills, including MS Office Suite Strong customer service and communication abilities Critical thinking skills with the ability to solve problems within established guidelines Capable of navigating multiple systems simultaneously and taking direction effectively Familiarity with administrative and clerical procedures, including word processing and file management Detail-oriented with a focus on accuracy Preferred: Prior experience with Medical Insurance Claims Processing Prior experience with Medicare/Medicaid Physical Demands Ability to safely and successfully perform the essential job functions consistent with the ADA and other federal, state, and local standards Ability to move about to accomplish tasks or move from one worksite to another Regularly access low and high spaces that may be at irregular angles such as under a desk Ability to conduct repetitive tasks on a computer, utilizing a mouse, keyboard, and monitor Must be able to communicate with customers/team members over the phone and in person #LI-NA1 Reasonable Accommodation Statement If you require a reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employment selection process, please direct your inquiries to application.accommodations@cai.io or (888) 824 - 8111. Equal Employment Opportunity Policy Statement It is the policy of CAI not to discriminate against any employee or applicant due to race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or being a protected veteran. It is also the policy of CAI to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or being a protected veteran, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Employees and applicants of CAI will not be subject to harassment due to race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or being a protected veteran. Additionally, retaliation, including intimidation, threats, or coercion, because an employee or applicant has objected to discrimination, engaged or may engage in filing a complaint, assisted in a review, investigation, or hearing or have otherwise sought to obtain their legal rights under any Federal, State, or local EEO law is prohibited.