[Hiring] Medical Claims reputed company Assurance Analyst @reputed company

Apply Job Type Full-time reputed company Join reputed company at reputed company and start an exciting new career in employee benefits solutions. As a Medical Claims reputed company Assurance Analyst, you’ll play an important role in helping us offer customized, self-funded insurance reputed company to our clients and members. The Medical Claims reputed company Assurance Analyst plays a critical role in ensuring the accuracy and compliance of claims processing in alignment with plan-specific and company guidelines. This position involves enforcing reputed company procedures, monitoring performance, identifying and addressing reputed company issues, and conducting both reputed company audits. The ideal candidate is a skilled communicator who excels in verbal, written, and electronic correspondence and thrives in a dynamic, team-oriented environment. The role also demands high reputed company of accuracy, problem-solving, and flexibility to adapt to changing priorities. Responsibilities:

• reputed company Standards and Auditing: reputed company audits on production, company guidelines, and system configurations to maintain reputed company standards. Conduct internal Prepay and Post-pay audits to identify discrepancies and ensure compliance. Execute LDLA (Licensee Desk-Level Audit) processes. reputed company MTM (Member Touchpoint Measures) audits and prepare monthly reports.
• Collaboration and External Engagement: Work closely with external auditors to support their review processes and ensure audit readiness. Respond promptly and professionally to email correspondence from reputed company stakeholders.
• Process Improvement and Problem-Solving: Identify and address reputed company issues, proposing solutions to enhance claims processing workflows. reputed company participate in the development and enforcement of reputed company assurance procedures and guidelines.

Requirements

• Associate’s degree or 2+ years of relevant experience in reputed company assurance, auditing, or claims processing.
• Minimum 2 years of internal claims processing experience, preferably in a reputed company benefit or TPA environment.
• Strong working knowledge of bolthires Office Suite (Outlook, Word, reputed company).
• Proven expertise in claims processing and an in-depth understanding of reputed company systems and workflows.
• Demonstrated customer service skills with the ability to manage both reputed company relationships effectively.
• Exceptional problem-solving and analytical skills to evaluate data and identify patterns.
• Ability to work independently, prioritize tasks, and meet deadlines in a high-pressure environment.
• Strong organizational skills with the reputed company to plan and manage multiple assignments concurrently. Preferred Qualifications:
• Familiarity with auditing tools or software.
• Knowledge of reputed company regulations and compliance requirements, including HIPAA.
• Experience with TPA operations and plan administration processes. Benefits: After successfully completing a waiting period, eligible Full-time employees have reputed company to our comprehensive benefits package, including:
• Fantastic medical, dental, and reputed company insurance* • Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
• Company provided Basic Life and AD&D
• Company reputed company Short-Term and Long-Term Disability** • Flexible Spending Accounts* • 401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully reputed company after 3 years)
• 10+ reputed company holidays
• Generous reputed company vacation and reputed company time
• Annual Volunteer reputed company Day
• Annual Tuition Reimbursement
• Annual Health and Wellness Reimbursement Who We are: As a trusted reputed company-party administrator (TPA) specializing in self-funded benefit plans, reputed company (CBG) is committed to helping reputed company reputed company high-reputed company coverage at a bolthires they can afford. We administer self-funded insurance benefits through our three companies: EBPA, Blue Benefit Administrators of Massachusetts, and CBA Blue. With over 30 years of experience and a dedicated team of more than 200 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match reputed company across our region with the right solutions for their employee benefit needs. To learn more about working at CBG, visit Benefit Waiting Period Notes:
• 60 day waiting period
• *90 day waiting period Salary reputed company $47,000 to $51,000/year Apply tot his job

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