Medical Claims Specialist

3 days ago


Appleton, Wisconsin, United States Lucent Health Solutions LLC Full time
Exceptional Customer Service Role at Lucent Health Solutions LLC

We are seeking a highly skilled Medical Claims Specialist to join our team at Lucent Health Solutions LLC. As a Medical Claims Specialist, you will be responsible for processing medical and dental claims, as well as disability, pharmacy, and flexible spending claims in a timely and accurate manner.

This is an excellent opportunity to work with a compassionate, human-focused, data-driven care management solution that enables health plan participants to make smarter, cost-saving healthcare decisions. Our approach combines top-tier claims management with continuous data analytics to ensure participants receive the right care, at the right cost, at the right time.

The ideal candidate will have 1-2 years of previous claims experience and possess strong knowledge of claims analyst processes and procedures. They will also have the ability to navigate through various PC applications efficiently and demonstrate excellent organizational skills, problem-solving, and decision-making skills.

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
  • Provide written correspondence and verbal information to members, group contacts, agents, and healthcare providers
  • Refer potential abuse, subrogation, and adjustment claims
  • Perform necessary check run process and communicate check register information

We offer a competitive salary of $62,000 per year and a dynamic work environment that fosters growth and development. If you are passionate about delivering exceptional customer service and possess the required skills and qualifications, we encourage you to apply for this exciting opportunity.

About Us:

Luent Health Solutions LLC is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.



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