Bright Health is delivering a smarter, more connected healthcare experience. Our affordable health insurance plans and exclusive partnerships with leading health systems are reshaping how people and physicians achieve better health. Today, Bright Health provides health insurance to individuals in Colorado, Arizona, and Alabama in both the Individual and Medicare Advantage space.
Come join our mission: Making Healthcare Right. Together!
The Claims Analyst will report to the Claims Director and is responsible for the overall day-to-day claim administration.
This work is critical to the company’s success. You will play an important role by ensuring claims timeliness and accuracy as we strive to deliver an optimal member and care partner experience.
- Day-to-day claim operation accountability as the point of contact with claim vendor (Cognizant) in providing timely claim processing guidance.
- Daily claim turnaround responsibility
- Researching and responding for claim escalations
- Creating, tracking and maintaining claims issue log
- Interfaces, as necessary, with members and / or providers related to claim issue resolution
- Facilitation of claim operations issue resolution and status meetings both internally and with claims vendor
- Supports new market claim implementation efforts
- Support of mandated claim audits
- Support of the claims quality assurance program
- Other duties and responsibilities as assigned
Supports the development and ongoing refinement of claim administration:
- vendor business requirements documentation
- policies and procedures
- desk level procedures