Medical Claims Analyst

Job Description

Job Description

We are looking for a dedicated Medical Claims Analyst to join our healthcare team in Minneapolis, Minnesota. In this long-term contract position, you will play a vital role in processing leave of absence claims, ensuring compliance with medical certifications, and calculating benefit allocations. This is an excellent opportunity to contribute to a fast-paced industry while leveraging your expertise in medical claims and benefits administration.

Responsibilities :

• Process and manage leave of absence claims by coordinating medical certifications and ensuring timely submissions.
• Calculate benefit amounts, including allocations from corporate and state sources, to ensure accurate disbursements.
• Review, approve, or deny claims based on established guidelines and medical documentation.
• Utilize systems such as ServiceNow and Workday to track, manage, and process claims efficiently.
• Maintain detailed records of claims and benefits to ensure compliance and accuracy.
• Communicate with healthcare providers to confirm certifications and resolve discrepancies.
• Address rejected claims by investigating issues and providing resolutions.
• Collaborate with team members to streamline leave administration processes.
• Provide guidance to employees regarding medical leave policies and benefits.
• Stay updated on state and federal regulations related to leave and benefits administration.
• Minimum of 3 years of experience in medical claims processing or a similar role.
• Strong knowledge of unemployment claims, medical benefits, and leave administration.
• Proficiency in handling leave requests and medical leave claims.
• Familiarity with systems such as Workday HCM and ServiceNow Platform.
• Ability to interpret and apply state and federal regulations related to insurance benefits.
• Excellent analytical and problem-solving skills to manage complex claims.
• Strong communication skills to interact with healthcare providers and employees.
• Attention to detail and organizational skills to ensure accurate record-keeping and compliance.