Sr Claims Analyst - LHB

At Luminare Health, our people are what set us apart. Their expertise, dedication, and passion for service excellence are the foundation of our success.We're committed to helping our employees grow through thoughtful development opportunities, meaningful work, and a culture that values collaboration and continuous improvement. When you join Luminare Health, you join a purpose-driven team focused on making healthcare simpler, better, and more affordable.Job SummaryThis position includes a variety of claim administrative and technical tasks that support a Claim Unit and/or vendor staff, as well as the Claims Team and serves as a liaison for any internal departments. In addition to these tasks, the Senior Claims Analyst is responsible for all of the same tasks as a Claim Analyst including the accurate adjudication and processing of medical, dental, vision, or other related claims, including related correspondence and/or electronic inquiries for assigned groups. All claims and inquiries are handled according to the established plan documents, claim processing guidelines, and established total turnaround times. Also advise team members regarding claim processing procedures.Life & Disability - Sr Claims AnalystSecure and analyze claim information to make life and disability benefit determinations in accordance with policy provisions and appropriate state and federal laws; achieving results by effective use of all appropriate resources. Calculate benefit payments and communicate claim decisions on new and continuing claims. Provide responsive and caring customer service. All tasks completed under general supervision of management.Required Job Qualifications:High School diploma or GED equivalent3 years prior medical claim processing experienceAbility to work in a fast-paced, customer centric & production driven environmentExcellent verbal and written communication skillsAbility to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staffDemonstrated critical thinking, to carry out instructions furnished in oral, written or diagram formFlexible; open to continued process improvementsSelf-directed individual who works well with minimal supervisionGood leadership, organizational and interpersonal skillsAbility to effectively handle with complex situations and reach resolutionAbility to analyze and interpret documents and Summary Plan Descriptions (SPDs)Ability to adapt to various system platforms, and to effectively use MS Excel/WordPreferred Job Qualifications:Health Insurance/Third Party Administrator ExperienceLife & Disability - Sr Claims AnalystMinimum Requirements:Minimum three-years life and/or disability claim administration experience: solid investigation, analytical and organizational skills along with attention to detail; or the equivalent combination of relevant experience.Must have strong math and decision-making skills.Must be able to work in ...