154 claims solutions analyst jobs found

At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.  Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers’ expectations while making a real impact for our company through our shared purpose.  When you join our company, we want you to feel valued, supported and proud to work here. That’s why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. GEICO is leading the charge in delivering superior customer service across our Contact Center operations, supporting over 9,000 agents in our Auto Service, Sales, Claims, Commercial, and Recreational product lines. We are committed to transformation, operational excellence and leveraging cutting-edge workforce management strategies, including the NICE WFM platform, PowerBI, Alvaria/Aspect, AWS Connect, to...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Business Operations Analyst Senior, you will consult with the business to understand and define opportunities and recommend solutions by analyzing data and providing key insights to inform decisions. Provide subject matter expertise on all matters of business analytical or operational data needs. Work closely with enterprise and business process owners to integrate data analytics into business processes to improve business performance. We offer a flexible work environment that requires an individual...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity Join our dynamic Reinsurance Operations team in the Life Actuarial department as a Reinsurance Analyst I (Mid-level)! This is an exciting opportunity to play a vital role in supporting reinsurance processes, from claims processing and treaty administration to financial reporting and audit support. You'll be responsible for managing reinsurance risk, ensuring regulatory compliance, and collaborating with business partners to drive effective decision-making. Strong critical thinking skills and excellent time...

As a Health and Benefits Senior Analyst, you will contribute to a wide variety of projects involving the design, financing and ongoing management of the full spectrum of health and benefit programs.   You will support the  project manager on select projects, interface with vendors and key clients internally and externally, create client deliverables, and ensure quality standards are met.  You will have the opportunity to significantly grow your health and benefits business acumen as well as your financial, project management and client relationship skills by working on cutting edge projects alongside leaders in the industry. Responsibilities: Materially contribute to core health and benefits projects supporting the design and management of group medical, dental, wellbeing, life, disability and absence management benefits for clients. Responsibilities include: Partnering with client service team leader to deliver superior project management Providing...

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! The Client Service Business Analyst – Program Client Services will provide strategic business analysis services to Program Services (Program Analyst-Accounting/Finance). This role is responsible for understanding business objectives, operational workflows, and client service needs to identify opportunities for process improvement, system efficiencies, and enhanced service delivery. The ideal candidate will collaborate with cross-functional stakeholders to translate business strategies and requirements into...

The Setup Team Lead is responsible for assisting and supporting   the Setup Supervisor with ensuring   the Setup Team meets protocol. This role will assist with supervisory functions when the Setup Supervisor is absent. The Setup Team Lead is responsible for ½ production. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Must maintain ½ production quota Organize and distribute claims according to established priority Provide guidance to analysts, aiding with resolution of problems or questions Process complex/problematic claims according to protocol Maintain production standards and production requirements Comply with standard protocol for processing problem claims Function as liaison between analysts and clients Professionally communicate with other offices and internal departments Train new team members Assist co-workers, supervisor and management in accomplishing production goals Maintain HIPAA compliance in all aspects of...

*This position is open to multiple U.S. locations*   The surplus lines tax analyst is responsible for coordinating timely filing and payment of surplus lines taxes to respective state(s). At most, six states will be the responsibility of one person.  As part of a team that files taxes, each analyst will be cross-trained in at least one other state to be able to support colleagues on and across teams. Primary tasks include running reports, filing taxes, investigating and resolving corrections, answering questions from field offices, and collaborating with state insurance departments. Responsibilities Timely and accurate completion of agency/individual regulatory surplus lines tax filing reports Provide professional advice and counsel internally regarding surplus lines taxes; Assist peers with finding and interpreting state regulations pertaining to surplus lines tax filings, as required Communicate with state...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity We have multiple exciting opportunities available on our Pricing, Indications , and Reserving teams.  As a dedicated Actuarial Analyst I , you will be a near-credentialed analyst responsible for independently applying complex technical and actuarial methodologies as well as requiring expert knowledge in one actuarial practice area (pricing, reserving, modeling, catastrophe risk, claims analytics, product management, etc.) to complete unstructured projects. This role is remote eligible in the continental U.S....

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the following locations: San Antonio, TX, Plano, TX, Phoenix, AZ, Colorado Springs, CO, Charlotte, NC, or Tampa, FL Relocation assistance is available for this position. We have multiple exciting opportunities available on our Modeling Factory and Insights & Development teams. As a dedicated Actuarial Analyst I, you will be a near-credentialed analyst responsible...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Business Rules Analyst Lead, you will lead in facilitating business requirements by means of design, workflow analyses and facilitated discussions with end users. Detailed understanding of supported technology to both manage and facilitate business needs when required. Translates users' business requirements for complex projects into detailed functional designs for development, testing and implementation. Applies methodologies and prepares detailed specifications and related documentation. Assists...

Responsible for receiving and entering medical claims while maintaining accuracy and meeting turnaround requirements. The Setup Analyst provides a higher level skillset, supporting the goals of the Setup department, personal growth, and of CorVel.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Ensure bill is eligible for MCS review Handle / organize bills to be entered in a timely fashion Enter bill proficiently and accurately into internal system Communicate any special handling of each claim Maintains production standards and production requirements Comply with standard protocol for processing problem claims Responsible for high profile clients, including production, QC, communications, etc. Train new employees Function as back-up for filter or filter leads Requires punctual and consistent attendance Must be willing and able to work overtime as required Assist co-workers, supervisor and management in accomplishing...

The Procurement Team Lead position is 50% production and 50% assisting and supporting direct supervisor with ensuring the team meets protocol, as well as performing supervisory duties during the supervisor's absence. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Monitor/Audit and reports for Procurement and clients Monitor/Audit files in Procurement staffs individual service queues via Management Console Tool for accuracy and timely claim processing Assist with Procurement QC queue tickets during high volume times Assist team members with all questions and concerns Answer emails and phone calls from both Procurement and other internal departments and also externally from Clients/Providers regarding any claims processing concerns Additional duties as assigned   KNOWLEDGE & SKILLS: Exceptional organizational skills Ability to work independently and in a team environment Ability to work in a fast paced/production...

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! The Senior Client Service...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity We have multiple exciting opportunities available on our Pricing, Indications , and Reserving teams.  As a dedicated Actuarial Analyst I , you will be a near-credentialed analyst responsible for independently applying complex technical and actuarial methodologies as well as requiring expert knowledge in one actuarial practice area (pricing, reserving, modeling, catastrophe risk, claims analytics, product management, etc.) to complete unstructured projects. We offer a flexible work environment that requires an...

The Payment Integrity Analyst is responsible for accurately reviewing and completing pre- and post pay claim audits based on client, policy, industry standards and/or CMS guidelines.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication Use clinical judgement to appropriately interpret and apply client policies along with CMS guidelines as it relates to reviews done by CERIS such as itemized bill, DRG and/or specialty audits Utilize applicable tools and resources to complete internal audits and/or appeals Timely completion of internal audits and/or appeals Attends clinical team meetings, company meetings, educational opportunities/trainings, and other meetings Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to use clinical judgment and analytical skills for...

This position is for our subsidiary: Claim Assist Technologies, LLC To know more, visit us at http://www.claimassist.com Job Title : Business Analyst Location : San Antonio, Texas (On-site) Job Type : Full-Time Industry : Insurance Technology / Software Development Salary Range: $75,000 – $90,000 Position Overview: We are seeking an experienced Business Analyst to join our on-site team in San Antonio. This role is critical in bridging the gap between our end users and offshore development team. The ideal candidate will have a strong understanding of software systems, exceptional communication skills, and the ability to handle support-related interactions directly with users. Key Responsibilities: · Gather and analyze business requirements to translate into functional specifications for system enhancements and fixes · Act as a liaison between stakeholders and offshore development teams to ensure clarity and alignment on technical solutions · Create user...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate with respective leadership on any issues or problems identified Maintain production standards, production requirements, and quality of work Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner Timely forward misdirected requests to the correct recipient Ensure strict confidentiality of all medical records, PHI, and PII Outbound calling may be needed Additional duties as assigned KNOWLEDGE & SKILLS: Ability to work independently...

Join AIG's Forensic Accounting Unit as a Senior Forensic Accounting Analyst to play a crucial frontline role that will make the most of your technical expertise.  Make your mark as a Forensic Analyst As a claims professional, you are respected for your deep accounting expertise. You balance the needs of multiple stakeholders, making sound decisions using data, analysis, experience, and judgment, along with a risk mindset. Ultimately, you take ownership for key outcomes. We are recruiting for a highly motivated individual to join our AIG Forensic Accounting Unit. This is a great opportunity to join a team that is striving to be the best forensic unit in the industry. How you will create an impact: Utilize accounting principles and techniques to obtain, interpret, record, and analyze a variety of data from all business types to assist in the quantification and the measurement of commercial business insurance claims. Work with a team and supervisors and be mentored...

Claims Management Analyst Join us as a Claims Analyst to grow your experience in handling complex claims. Make your mark in Claims. Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency.  How you will create an impact Analyzing the scope and extent of coverage of primary policies with deductibles. Clear and concise written and verbal communication with insureds, TPAs, brokers and underwriters. Make regular and appropriate contact with internal and external customers including leading national Fortune 500 companies. Give guidance to insureds and/or brokers to manage expectations. Effectively strategize and...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity The Director, Decision Science Analytics is a Finance analytics leader supporting both the Chief Accounting Office and Chief Investments Office at USAA. This role owns the analytics delivery across General Accounting, Tax, Internal Controls, External Reporting, Reconciliations, and Corporate Investments. The Director drives insights and modernizes Finance's capabilities by automating manual processes and building scalable, trusted data solutions on enterprise platforms. This leader serves as the critical analytics...