Claims Analyst - Armada Solutions : Job Details

Summary: This key role is at the heart of what we do at Armada - pay our members claims! The Claims Analyst is responsible for reviewing portal entry claims, conducting error correction and quality control reviews, as well as final adjudication of paper and electronic claims. The ideal Claims Analyst will be analytical and have an interest in digging in to find the right answer, all while meeting our high excellence and service standards. They will have good communication skills and be comfortable working with high-profile clients. Tasks/Responsibilities:

• Apply product, plan provisions, SOPs, benefit limits and policy exclusions to determine the next steps for a claim
• Process claims, including all associated tasks - benefit eligibility verification, determining the appropriateness of a claim, etc
• Acquire additional claims substantiation, as needed
• Complete related tasks such as claim identifications, member communication, and closing of said claims
• Use multiple systems and tools to answer service requests and inquiries received from various channels
• Research and resolve other general customer account inquiries as appropriate
• Review charges and use of payment or denial codes within established guidelines and standards
• Maintain records, files, and documentation
• Meet or exceed the standards of department production and quality
• Such other duties or tasks to assist the department of organization as the supervisor may deem necessary.

Skills/Requirements:

• Must be proficient in MS Word, Excel, and Outlook.
• Excellent verbal and written communication skills required
• Deeply analytical with the ability and interest to research and solve the puzzle
• Strong attention to detail and an eye for accuracy
• Must have a good command of the English language, oral, and written
• Must be able to work in a fast-paced environment with demonstrated ability to handle multiple tasks
• Ability to maintain confidentiality
• Ability to deal with difficult people and problems
• Able to work well in a team environment and with a diverse group of people
• Ability to work mandatory overtime during busy periods
• Ability to meet established carrier deadlines

Physical Demands:

• Ability to sit for long periods of time

Benefits:

• Medical, Dental, and Vision insurance
• Employer-sponsored Health Savings Account OR Employer-paid enrollment in an Armada supplemental insurance plan
• Flexible Spending Accounts (medical and dependent care)
• Employer-paid life insurance
• Employer-paid long-term disability insurance
• Short-term disability insurance
• 401(k) retirement plan with employer match
• Paid time off
• Eight paid holidays per year
• Free access to onsite gym at Hunt Valley office location
• Patient to Physician matching service
• Travel assistance program
• Employee Assistance Program (EAP)
• Employee referral bonus program - earn up to $1500 per hire
• Professional development opportunities
• Voluntary benefits and discount programs
• Hybrid work environment
• Company events
• Employer-sponsored philanthropy initiatives

Probationary Period: This role will have a three (3) month probationary period during which time management will have an opportunity to determine whether a person is able to perform all required duties of employment. Details related to job expectations and production metrics will be provided by management. This role is primarily remote with the requirement to be in office Tuesday - Thursday during the second week of the month. 40+ hours per week. Overtime required during busy seasons.