Top 67 Claims business Jobs in Buffalo, Ny

Claims Business Analyst
Centivo —Buffalo, NY
- $80,000 - $100,000 a year
- Full-time
- Remote
- Research
- 3 years
- SQL
- Health insurance
[Entry Level] Business Banking Operations Associate (Loan Workout Support) - Hybrid
M&T Bank —Getzville, NY
- $18.68 - $31.14 an hour
- Full-time
- Hybrid work
- Microsoft Outlook
- Research
- Office
Associate Underwriter
Highmark Inc. —Buffalo, NY
- $27.02 - $41.85 an hour
- Full-time
- Hybrid work
- Computer Science
- No experience needed
- Office
Coordinator, Quality Assurance
NEW ERA CAP LLC —Buffalo, NY
- $50,000 - $60,000 a year
- Full-time
- Microsoft Excel
- Research
- Mid-level
- Health insurance
- Paid time off
Quick Apply
10d
Analyst I, Insurance Compliance
Arbor Realty Trust —Tonawanda, NY
- $60,000 - $65,000 a year
- Office
- Finance
- High school diploma or GED
- 401(k)
- Paid time off
Human Resource Business Partner - FT - Day Shift
Erie County Medical Center —Buffalo, NY
- $76,500 - $90,000 a year
- Part-time
- Writing skills
- Mid-level
- Master's degree
Employee Relations Consultant
KeyBank National Association —Amherst, NY
- $57,000 - $87,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Mid-level
13d
REVENUE CYCLE SPECIALIST, BUSINESS OFFICE
PEOPLE INC. —Williamsville, NY
- $21 an hour
- Monday to Friday
- Medical office experience
- Mid-level
- Office
11d
Automotive Account Manager
AAA Western and Central New York —Williamsville, NY
- $60,000 - $71,000 a year
- Weekends as needed
- Mid-level
- Office
- 3 years
- Paid training
- AD&D insurance
Small Business Commercial Lines Account Manager
AAA Western and Central New York —Williamsville, NY
- $27.62 - $30.69 an hour
- Weekends as needed
- Hybrid work
- Mid-level
- Office
- Business development
- Paid training
- AD&D insurance
Claims Specialist
BestSelf Behavioral Health —Buffalo, NY
- From $19.50 an hour
- Full-time
- Microsoft Outlook
- Basic math
- Mid-level
- Health insurance
- Tuition reimbursement
Quick Apply
ESIS Senior Claims Representative, WC
Chubb —Cheektowaga, NY
- $71,000 - $104,000 a year
- Full-time
- Analysis skills
- Bachelor's degree
- Continuous improvement
Quality Measurement & Improvement Analyst-Senior
Independent Health —Buffalo, NY
- $85,000 - $95,000 a year
- Full-time
- Master's degree
- SQL
- Bachelor's degree
- Paid time off
Finance Operations Analyst
Onebridge Benefits Inc —Buffalo, NY
- $23 - $26 an hour
- Mid-level
- Office
- Finance
- Free parking
Quick Apply
Office & Payroll Administrator
Atlas Copco Group —Buffalo, NY
- $68,600 - $85,700 a year
- Microsoft Excel
- Microsoft Outlook
- Research
- AD&D insurance
- Paid holidays
Commercial Lines Account Manager
AAA Western and Central New York —Williamsville, NY
- $62,500 - $77,500 a year
- Weekends as needed
- Hybrid work
- Computer literacy
- Mid-level
- Office
- Paid training
- AD&D insurance
Product Development Specialist
Philadelphia Insurance Companies —Amherst, NY
- $76,700 - $85,700 a year
- Online Application
- Research
- Mid-level
- Office
- Health insurance
- Tuition reimbursement
Medical Billing Coordinator (Full Time/Mon-Fri 8a-4p)
Cazenovia Recovery Systems Inc —Buffalo, NY
- $28 - $29 an hour
- Full-time
- Mid-level
- 3 years
- Analysis skills
Epic Denials Management Operator
Deloitte —Williamsville, NY
- $70,000 - $90,000 a year
- Full-time
- Microsoft Excel
- Mid-level
- Bachelor's degree
Epic Denials Management Coordinator
Deloitte —Williamsville, NY
- $50,000 - $60,000 a year
- Full-time
- Microsoft Excel
- Mid-level
- Bachelor's degree

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Claims Business Analyst

Centivo -
Buffalo, NY

Apply Now

Job Details

Full-time
$80,000 - $100,000 a year

Benefits

Health insurance

Qualifications

Health insurance policy knowledge
Medical claims processing software
Technical troubleshooting support
Productivity software
Query management
Cross-functional collaboration
Health insurance management
Cross-functional communication
Data analysis software

Full Job Description

We exist for workers and their employers - who are the backbone of our economy. That is where Centivo comes in - our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.

Summary of role:

As a Claims Business Analyst, you will be responsible for triaging operational issues and leading projects and tasks to completion. You will use your claims adjudication experience and TPA background to triage operational concerns, vendor issues, and related claims issues. Familiarity with Centivo’s claims systems (Javelina and HealthRules Payer) is preferred. You will coordinate with all business units and external vendors during client implementations and conversions to determine requirements. This role ensures seamless integration between internal and vendor systems to support client requirements and operational workflows. Additionally, you will lead key projects and tasks identified to improve efficiency of Centivo’s Claim team. This role will use data analytics and other tools to identify areas of improvement needed in the business, scope out the initiative, and then lead the project through to completion.

Responsibilities Include:

Support the Centivo Claims Team with troubleshooting issues, identifying the root cause and magnitude, and then researching and recommending the best solution.
Effectively work with end-users and operational partners to identify business needs and to ensure implementations meet business requirements and appropriately address prioritized needs.
Develop and maintain advanced reporting, dashboards, KPI’s and business insights to support operational decision-making through measurement of performance and effectiveness of processes.
Assist with creating Process Flows on new initiatives and existing processes as needed.
Function as a liaison between business and technical resources to ensure people, processes, and solutions meet or exceed the needs of our Clients and Operational areas.
Pull and analyze daily, weekly, and monthly operational reports to support Claims Operations, monitor team performance, identify trends, and provide actionable insights to leadership.
Work with business partners to identify and articulate business requirements in each area. Facilitate brainstorming sessions to review solution options that will solve business needs.
Assist and participate in the claims testing process for new technology, vendor, and processes.
Proactively keep abreast of vendor enhancements as well as how they integrate with existing solutions.
Collaborate with the Subject Matter Expert (SME) on all aspects of the functionality of the Claims systems and act as the primary liaison with the vendor for reported issues and enhancement requests.
Work with the team on oversight of the implementation of claims platform upgrades and supporting technologies. This includes coordinating user acceptance testing with the operational leads.
Proactively identify opportunities and recommend system solutions that increase automation, resolve system deficiencies, and enhance claims processing and reporting to meet and exceed business requirements.
Participate in the assessment of new technologies, new vendors, and any system enhancements being contemplated.
Participate in internal and external meetings for plan design, strategy, and setup.
Query data or create reporting to support analysis of issues, trends or specific reporting needs for clients or providers related to claim performance.
Performs other duties as deemed essential and necessary.

Required Skills and Abilities:

Advanced problem-solving skills, with a track record of researching and resolving operational issues accurately and on time.
Highly organized and able to work independently, using sound judgment to manage priorities and make decisions.
Adapts to changes in the work environment; manages competing demands and deals effectively with frequent changes, delays, or unexpected events, including production schedule pressure.
Builds strong working relationships and influences outcomes across cross-functional teams.
Proficiency in Microsoft Office and other web-based software applications.
Skilled in running queries and analyzing data to identify trends and issues.
Excellent verbal and written communication skills — able to explain complex or technical information clearly, and to understand and interpret complex information from others, including reimbursement policy standards.

Education and Experience:

Candidates must have at least 5 years of experience within healthcare claims
Candidates must have 3 years of experience working as a Business Analyst
Candidates must have prior experience with highly automated and integrated claim adjudication systems
Understanding of health insurance benefits administration in a self-funded environment

Preferred Qualifications:

Experience working with El Dorado-Javelina or HealthRules Payer
Experience working at TPA
Experience with self-funded plans
Proficient in SQL, Tableau and JIRA
Intermediate to advanced proficiency in MS Excel

Work Location:

Preference for Buffalo Office
Open to Remote

Centivo Values:

Resilient – This is wicked hard. There is no easy button for healthcare affordability. Luckily, the mission makes it worth it and sustains us when things are tough. Being resilient ensures we don’t give up.
Uncommon - The status quo stinks so we had to go out and build something better. We know the healthcare system. It isn't working for members, employers, and providers. So we're building it from scratch, from the ground up. Our focus is on making things better for them while also improving clinical results - which is bold and uncommon.
Positive – We care about each other. It takes energy to do hard stuff, build something better and to be resilient and unconventional while doing it. Because of that, we make sure we give kudos freely and feedback with care. When our tank gets low, a team member is there to be a source of new energy. We celebrate together. We are supportive, generous, humble, and positive.

Who we are:

Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com.

Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.

Compensation Range: $80K - $100K

Apply Now

Refine Your Search

claims business jobs in buffalo, ny

Claims Business Analyst

[Entry Level] Business Banking Operations Associate (Loan Workout Support) - Hybrid

Associate Underwriter

Coordinator, Quality Assurance

Analyst I, Insurance Compliance

Human Resource Business Partner - FT - Day Shift

Employee Relations Consultant

REVENUE CYCLE SPECIALIST, BUSINESS OFFICE

Automotive Account Manager

Small Business Commercial Lines Account Manager

Claims Specialist

ESIS Senior Claims Representative, WC

Quality Measurement & Improvement Analyst-Senior

Finance Operations Analyst

Office & Payroll Administrator

Commercial Lines Account Manager

Product Development Specialist

Medical Billing Coordinator (Full Time/Mon-Fri 8a-4p)

Epic Denials Management Operator

Epic Denials Management Coordinator

I want to receive the latest job alert for claims business in buffalo, ny

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