Lucent Health Solutions, Inc.
Claims Analyst
Lucent Health Solutions, Inc., Nashville, Tennessee, United States, 37247
Hybrid: Nashville TN or Appleton WI
About Lucent Health
Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers.
Company Culture
We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health.
HonestTransparent Communication: be open and clear in all interactions without withholding crucial informationIntegrity: ensure accuracy in reporting, work outputs and any tasks assignedTruthfulness: provide honest feedback and report any issues or challenges as they ariseTrustworthiness: build and maintain trust by consistently demonstrating reliable behaviorEthical
Fair Decision Making: ensure all actions and decisions respect company policies and valuesAccountability: own up to mistakes and take responsibility for rectifying themRespect: treat colleagues, clients and partners with fairness and dignityConfidentiality: safeguard sensitive information and avoid conflicts of interestHardworking
Consistency: meet or exceed deadlines, maintaining high productivity levelsProactiveness: take initiative to tackle challenges without waiting to be askedWillingness: voluntarily offer to assist in additional projects or tasks when neededAdaptability: work efficiently under pressure or in changing environmentsSummary
Our Claims Analyst processes medical, dental, disability, pharmacy, and flexible spending claims. In addition, they certify the check run process in a timely and accurate manner The analyst also provides exceptional customer service and claim resolution for their assigned groups, and members and check run process in a timely and accurately manner.
Responsibilities
Process medical and/or dental claims, as well as disability, pharmacy, flexible spending, or vision claims, if applicable.
Interpret and apply specific plan document language as well as determine eligibility for benefits during claims adjudication.Works collaboratively with claims administration, client services, account management and check run for Lucent Health client groups.Provide written correspondence and verbal information to members, external and internal group contacts, agents, and healthcare providers.Refer potential abuse, subrogation, and adjustment claims.Perform necessary check run process and communicate check register information.Maintain a positive and professional attitude.Meet quality and production requirements and adhere to expectations determined by the claims department.Qualifications:
High School Diploma / GED (or higher)Strong analytical skill set: must have the ability to identify and solve discrepancies.Ability to navigate through and utilize 25+ PC applications efficiently.Strong organizational skills, problem solving, and decision-making skills required.Self-directed and starter skills required.1+ years of experience in a related environment, claims processing, medical coding, or billing preferred.Working hours: 8:00AM to 5:00PM M-Th, Friday 8:00AM to 4:00PM.Demonstrated written and oral communication skills required.
About Lucent Health
Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers.
Company Culture
We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health.
HonestTransparent Communication: be open and clear in all interactions without withholding crucial informationIntegrity: ensure accuracy in reporting, work outputs and any tasks assignedTruthfulness: provide honest feedback and report any issues or challenges as they ariseTrustworthiness: build and maintain trust by consistently demonstrating reliable behaviorEthical
Fair Decision Making: ensure all actions and decisions respect company policies and valuesAccountability: own up to mistakes and take responsibility for rectifying themRespect: treat colleagues, clients and partners with fairness and dignityConfidentiality: safeguard sensitive information and avoid conflicts of interestHardworking
Consistency: meet or exceed deadlines, maintaining high productivity levelsProactiveness: take initiative to tackle challenges without waiting to be askedWillingness: voluntarily offer to assist in additional projects or tasks when neededAdaptability: work efficiently under pressure or in changing environmentsSummary
Our Claims Analyst processes medical, dental, disability, pharmacy, and flexible spending claims. In addition, they certify the check run process in a timely and accurate manner The analyst also provides exceptional customer service and claim resolution for their assigned groups, and members and check run process in a timely and accurately manner.
Responsibilities
Process medical and/or dental claims, as well as disability, pharmacy, flexible spending, or vision claims, if applicable.
Interpret and apply specific plan document language as well as determine eligibility for benefits during claims adjudication.Works collaboratively with claims administration, client services, account management and check run for Lucent Health client groups.Provide written correspondence and verbal information to members, external and internal group contacts, agents, and healthcare providers.Refer potential abuse, subrogation, and adjustment claims.Perform necessary check run process and communicate check register information.Maintain a positive and professional attitude.Meet quality and production requirements and adhere to expectations determined by the claims department.Qualifications:
High School Diploma / GED (or higher)Strong analytical skill set: must have the ability to identify and solve discrepancies.Ability to navigate through and utilize 25+ PC applications efficiently.Strong organizational skills, problem solving, and decision-making skills required.Self-directed and starter skills required.1+ years of experience in a related environment, claims processing, medical coding, or billing preferred.Working hours: 8:00AM to 5:00PM M-Th, Friday 8:00AM to 4:00PM.Demonstrated written and oral communication skills required.