Schedule:
Mon-Fri start times between 7:00 AM – 9:00 AM (HYBRID AFTER TRAINING)
Job Summary:
The Claims Analyst will manage, review, and process reimbursement requests within the health benefits sector. Acting as a critical liaison between internal teams, insurance carriers, third-party administrators (TPAs), and clients, this role ensures accuracy, compliance, and efficiency in claim resolution. This position features a comprehensive training program designed to ground the analyst in specialized industry models, making it an excellent opportunity for professional growth.
Essential Job Duties:
- Review reimbursement requests for accuracy and completeness; submit verified claims to insurance carriers in alignment with company and regulatory guidelines.
- Monitor outstanding claims actively, maintaining detailed tracking logs and pursuing carriers to ensure timely financial reimbursements.
- Oversee and update monthly claim reports for a designated book of business.
- Evaluate plan eligibility documentation and coordinate the necessary internal and external approvals.
- Distribute reimbursements, convey updates to stakeholders, and assist with year-end account closeouts and reconciliations.
- Maintain professional, clear, and proactive correspondence via phone and email with carriers, brokers, TPAs, and clients.
- Partner closely with the Claims Manager and Claims Lead,
Requirements:
- Prior experience in health insurance claims processing or medical claims management.
- Strong proficiency in data tracking, documentation management, and financial/claim report reconciliation.
- Strong Excel proficiency.
- Ability to learn and operate within claims systems and structured workflows.
Nice to have:
- Prior experience working with self-funded health plans.
- Familiarity with Stop Loss insurance (though comprehensive training is provided).
Why apply?
- Hybrid schedule with regular WFH Mondays and Fridays, plus 12 additional remote flex days per year.
Onsite 100% first 90 days
After training: hybrid schedule
Tuesday–Thursday - onsite
Monday & Friday - remote
- Annual performance reviews offering 3%–5% pay increases and clear promotional paths after 1 year.
- Comprehensive benefits package including generous PTO and paid company holidays.
- Stable, expanding organization with a highly collaborative and supportive team culture.
- Major company perks, including an annual holiday celebration featuring high-end giveaway prizes (designer goods, electronics, cash, and trips).
About Medix?
Medix is dedicated to positively impacting lives every day. Since 2001, we have made it our mission to be the leading provider of workforce solutions for clients and candidates across the Healthcare, Scientific, and Information Technology industries.
Our dedicated recruiters are here to help you find and secure just the right opportunity. We take the time to learn about you, your skills, your interests, and your career goals, and then match you with the jobs and companies that best suit your needs. Whether you are looking for a contract, contract-to-hire, or direct hire positions, we can help you to find the meaningful and gratifying work that you've been looking for.
- Minimum Essential Coverage (MEC) plan
- Two different fixed indemnity plan add-ons
- Major Medical Plans, including 1 HSA Plan
- Dental
- Vision
- Short-term disability
- Life and AD&D
This year’s recipient of the Business Ledger's "Entrepreneurial Excellence Growth Award"
Join our network of talented professionals!
Pay: $45,760.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
- Work from home
Application Question(s):
- Do you have any experience in self-funded health plans? If so, for how long?
- Do you have any experience in Claims Processing? If so, for how long?
Work Location: In person
