Alight
Claims Analyst
Estimated salary
Job description
Our Story
At Alight, we believe a company’s success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to “Be Alight.” We are passionate about connecting purpose with impact. Alight empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management.
Our Benefits
With a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and vision coverages starting Day One. Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities – all within a thriving global organization.
Flexible Working
So that you can be your best at work and home, we consider flexible working arrangements wherever possible. Alight has been a leader in the flexible workspace and “Top 100 Company for Remote Jobs” 6 years in a row.
Great Place to Work
Thanks to the work of every colleague, Alight has received multiple awards of recognition including “Great Place to Work” for the past 7 years and Fortune’s “Best Companies to Work For.” To learn more about our company culture and awards Click Here.
If you, Champion People, seek to Grow with Purpose, and embody the meaning of Be Alight – We invite you to join our team! Learn more at careers.alight.com.
We are now hiring ambitious, motivated Claim Analysts to work in our team focused, premier healthcare navigation business. In this role, you will be leveraging acquired knowledge to deliver high quality customer interactions that are consultative and lead to better healthcare outcomes. Through this role, you will have the opportunity to positively impact the lives of employee customers and their families, while driving increased benefit satisfaction and reducing healthcare spend for their employers.
We Offer You
A competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization:
A full Benefits Package, starting on your first day of employment
Health, Dental, Vision, Life Insurance and more.
A 401k plan that includes a corporate match.
Paid Time Off
10 paid holidays per calendar year (8 fixed and 2 floating)
6 paid wellness days
Career Development & Growth:
We provide ongoing training, coaching and development. We reward continuous improvement and encourage you to own your own development. Take advantage of some of the best training and tools in the world to learn more about multiple areas of Human Resources!
Alight provides a collaborative environment that embodies and holds the following stated values close to heart: Champion people, Grow with purpose, and Be Alight.
As a Claims Analyst, you can expect the following:
When you start, you will receive extensive health care training to ensure you are equipped to consult members on billing related issues
Your primary responsibility is to be an advocate for members by working on their behalf with carriers, providers, and plan related documentation to resolve post-service coverage questions and/or issues in an accurate and timely manner. Activities include, but are not limited to the following:
Assist in reviewing medical, dental, vision, and pharmacy related claims for accuracy to ensure members are receiving the proper benefit coverage according to plan stipulations
Coordinate with providers and carriers to solve billing discrepancies, coding errors, and denied claims; assist with claim resubmission, as necessary
Draft, submit, and exhaust appeals processes, as necessary
Partner directly with client to bring awareness to unique care/billing situations that may require special review
Coordinate with providers to determine payment plan and discount options
This work involves leveraging developed methodologies, navigating internal tools, and applications, as well as making external phone calls, and partnering with carriers and providers (via email and phone outreach) to resolve member needs. The scope of work is dedicated at the employee level and you will be responsible for working cases through resolution.
Required Qualifications
Bachelor’s Degree, Associate’s Degree with 2 years billing/insurance experience, or 3 years’ experience in a healthcare billing/insurance related role
Ability to work effectively in a remote team environment
Strong problem solving, reasoning, and analytical skills
Exceptional verbal and written communication skills – ability to articulate complex billing concepts for members that are not experts
Strong ability and desire to learn continually in a changing environment
Ability to efficiently organize work activities to meet deadlines
Passion to provide the highest level of client satisfaction
Ability to receive and immediately apply constructive feedback
Ability to develop effective rapport with clients based on empathy and trust
Preferred Qualifications
Expertise and current knowledge of Medicare, Health accounts (FSA, HRA, HSA), and claims adjudication process
Application and Interview
By applying for a position with Alight, you understand that, should you be made an offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight’s employment policies. Background checks may include some or all the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal check, search against global sanctions and government watch lists, credit check, and/or drug test. You will be notified during the hiring process which checks are required by the position.
Alight requires all virtual interviews to be conducted on video. Please be aware that Alight is a camera-on culture and may require occasional travel to one of our physical office locations.
Our commitment to Inclusion
We celebrate differences and believe in fostering an environment where everyone feels valued, respected, and supported. We know that diverse teams are stronger, more innovative, and more successful.
At Alight, we welcome and embrace all individuals, regardless of their background, and are dedicated to creating a culture that enables every employee to thrive. Join us in building a brighter, more inclusive future.
As part of this commitment, Alight will ensure that persons with disabilities are provided reasonable accommodations for the hiring process. If reasonable accommodation is needed, please contact alightcareers@alight.com.
Equal Opportunity Policy Statement
Alight is an Equal Employment Opportunity employer and does not discriminate against anyone based on sex, race, color, religion, creed, national origin, ancestry, age, physical or mental disability, medical condition, pregnancy, marital or domestic partner status, citizenship, military or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state, or local law. In addition, we take affirmative action to employ disabled persons, disabled veterans, and other covered veterans.
Alight provides reasonable accommodations to the known limitations of otherwise qualified employees and applicants for employment with disabilities and sincerely held religious beliefs, practices and observances, unless doing so would result in undue hardship. Applicants for employment may request reasonable accommodations/modifications by contacting their recruiter.
Authorization to work in the Employing Country
Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not, now or in the future, require sponsorship of a visa for employment authorization in the Employing Country and with Alight.
We offer you a competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization.
Salary Pay Range
Minimum :
45,000.00 USDMaximum :
55,000.00 USDPay Transparency Statement: Alight considers a variety of factors in determining whether to extend an offer of employment and in setting the appropriate compensation level, including, but not limited to, a candidate’s experience, education, certification/credentials, market data, internal equity, and geography. Alight makes these decisions on an individualized, non-discriminatory basis. Bonus and/or incentive eligibility are determined by role and level. Alight also offers a comprehensive benefits package; for specific details on our benefits package, please visit: Wellbeing and Benefits Selector Page - Alight
DISCLAIMER:
Nothing in this job description restricts management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units.
