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Highlight Health

Senior Health Insurance Claims Analyst

Philadelphia, Pennsylvania, United States
Remote friendly

Passionate about data and healthcare? Want to work on projects that serve diverse clients and help to make a difference in people’s lives? Want to join our fight against costly medical bills for those who can least afford them?

If you answered yes, then you might be the perfect fit for our Senior Health Insurance Claims Analyst position at Highlight Health!

Who We Are:

Highlight Health is a small, rapidly growing start-up company, and we are on a mission to fight against high-cost hospital bills and make healthcare more transparent and fairer to everyone by using data-driven methods and innovative technologies to identify and eliminate fraud, waste, abuse, and over-priced bills in the healthcare industry.

We will count on you to analyze larger and highly complex claims for savings opportunities. Specifically, you will:

  • Acquire and organize additional data required for the analysis
  • Analyze claims using claims analysis templates and your professional claims knowledge
  • Create and present claim resolution recommendations to your Leaders or the Executive Team
  • Complete the claims resolution process
  • Help Highlight Health improve the claims analysis and resolution process
  • Train and provide oversight for entry-level claims data analysis
  • Assist entry-level employees with claims that require additional expertise

What will you get from us?

  • Work alongside passionate, critical-thinking colleagues who have deep health insurance knowledge and expertise
  • Be part of a team that is on the cutting edge of health care reform
  • Receive training and support while you engage in hands-on learning and skills development
  • Work with well-known clients who are highly regarded in the healthcare industry.
  • Enjoy a small company experience where you will be involved in the full data cycle from initial intake to final report
  • Have the chance to make a difference in healthcare costs and outcomes for those in the greatest need financially.

Bonus points if you have:

  • Demonstrated biology, medical, or medical coding knowledge from courses, certificates, or work experience
  • Familiarity/Experience with Waterfall, Agile, Scrum, Kanban, or other types of project management practices
  • Expertise in full cycle claims data analysis
  • Knowledge and experience in dealing with health claims fraud, waste, abuse, and overpricing tactics
  • College degree in a related field or equivalent work experience in the healthcare industry
  • Proven effective organizational and time-management skills
  • Analytical capabilities
  • Demonstrated exceptional attention to detail
  • Effective interpersonal skills working with clients, colleagues, and leaders
  • Aptitude with computer systems and skilled in learning new systems and procedures
  • Our salaries are competitive and reflect your experience, skills, training, capabilities, certifications, and knowledge. Our benefits package includes health insurance, 401(k) matching, sick time, paid time-off, and training/development opportunities.
  • Diversity and inclusion is a priority, and we do not discriminate based on race, creed, color, national origin, ancestry, marital status, gender identity or expression, sexual orientation, or sex – nor do we welcome anyone that does.
  • We are a small company with a big vision and a friendly, caring culture. You will have the opportunity to work closely with our leadership team and have a direct impact on our growth and success. You will also enjoy a flexible work environment where you can balance your personal and professional goals.

Key informations

Posted 15 days ago

Data-driven methods
Healthcare industry
Claims analysis
Health insurance knowledge
Healthcare costs
Healthcare outcomes

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