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Work From Home (HB), United States of America

Sr Claims Analyst - LHB.

REMOTESENIOR LEVELSALES & MARKETING$18–33/YR
At Dearborn, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This 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 Analyst Secure 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 equivalent 3 years prior medical claim processing experience Ability to work in a fast-paced, customer centric & production driven environment Excellent verbal and written communication skills Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff Demonstrated critical thinking, to carry out instructions furnished in oral, written or diagram form Flexible; open to continued process improvements Self-directed individual who works well with minimal supervision Good leadership, organizational and interpersonal skills Ability to effectively handle with complex situations and reach resolution Ability to analyze and interpret documents and Summary Plan Descriptions (SPDs) Ability to adapt to various system platforms, and to effectively use MS Excel/Word Preferred Job Qualifications: Health Insurance/Third Party Administrator Experience Life & Disability - Sr Claims Analyst Minimum 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 a deadline driven, fast-paced environment. Self-motivated with high learning agility. Must have excellent verbal and written communication skills with a passion for helping others. Must be a self-starter with strong time management skills to prioritize workload, manage and follow-up on numerous tasks. Capable of making decisions in the absence of specific directions, independently or with minimal supervision. Ability to effectively cope with change and shift gears accordingly in a dynamic environment. Must display a strong commitment to teamwork and have the ability to work in a collaborative environment. Effective in the use of personal computers and related software. Proficiency in working with Word, Excel and Outlook, Access preferred. Preferred: Four-year college degree in medical and/or business field a plus. Understanding of medical terminology Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Dearborn, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. Dearborn Group Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $18.07 - $33.92 Exact compensation may vary based on skills, experience, and location. Join our talent community and receive the latest Dearborn news, content, and be first in line for new job opportunities. Join our Talent Community. Dearborn Group is the trade name for Dearborn Life Insurance Company. Since 1969, we have been providing ancillary benefits to employer groups across the country. As the ancillary subsidiary of Health Care Service Corporation (HCSC), we designed our suite of employer-paid and voluntary insurance solutions—life, short- and long-term disability, vision, critical illness and accident insurance—to help employers provide a comprehensive benefits package that gives their employees and their families complete peace of mind. Dearborn Life Insurance Co, a subsidiary of Health Care Service Corporation, is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can contact us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through Dearborn Group's Career website on-line application process. Dearborn Group is an Equal Opportunity Employment employer. Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © 2019 Dearborn Group brand companies. All Rights Reserved.
Pay
$18–33/yr
Where
Work From Home (HB), United States of America
Work
Remote
Type
Not stated
Posted
26 Aug, 2026
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