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Job Details

Medicare Advantage (MA) Claims Analyst at Bright Health
Minneapolis, MN, US

ABOUT US

 

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!

 

YOUR RESPONSIBILITIES

 

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. 

 




ROLE RESPONSIBILITIES:





      • 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




 





ATTRIBUTES:




    • Bachelor’s degree in a related field is preferred.

    • A minimum of five (5) years of professional experience, with a minimum of two (2) years’ experience and expertise in Medicare Advantage claim operations

    • Strong critical thinker and problem solver ability

    • Effective communication skills and demonstrated ability to collaborate cross-departmentally and with vendor partners

    • Proficiency in Microsoft applications 





We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!