Senior Benefits Claim Analyst
Prime Communications, Sugar Land, TX, United States
Job Title
Required Qualifications Bachelor's degree in Finance, Healthcare Administration, Business, or related field 510+ years of experience in benefits, claims analysis, or payer-side operations Strong understanding of: o Medical and pharmacy claims o Claims adjudication and payer methodologies o Self-funded plans and stop-loss mechanics o Benefits administration and billing processes Advanced Excel and data analysis skills --- Preferred Qualifications Experience with a major health insurer (BCBS experience strongly preferred) Experience working with TPAs, stop-loss carriers, and pharmacy benefit managers Experience supporting or managing benefits within a self-funded employer environment
Required Qualifications Bachelor's degree in Finance, Healthcare Administration, Business, or related field 510+ years of experience in benefits, claims analysis, or payer-side operations Strong understanding of: o Medical and pharmacy claims o Claims adjudication and payer methodologies o Self-funded plans and stop-loss mechanics o Benefits administration and billing processes Advanced Excel and data analysis skills --- Preferred Qualifications Experience with a major health insurer (BCBS experience strongly preferred) Experience working with TPAs, stop-loss carriers, and pharmacy benefit managers Experience supporting or managing benefits within a self-funded employer environment