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Full-Time

Sr LTD Claims Analyst

Posted on 10/29/2024

HCSC

HCSC

Health insurance provider in multiple states

Financial Services
Healthcare

Compensation Overview

$53.5k - $118.1kAnnually

Mid, Senior

Remote in USA

Fully remote role.

Category
Insurance
Finance & Banking
Required Skills
Financial analysis
Requirements
  • BA/BS or equivalent combination of education and insurance industry experience.
  • 3 years of claims adjudication experience with LTD disability claims.
  • Experience with computer applications Word, Excel, Outlook desired.
  • Work experience in decision-making and information analysis.
  • Ability to meet deadlines while balancing competing demands.
  • Good math and calculation skills.
  • Experience meeting or exceeding quotas.
  • Experience establishing and maintaining cooperative working relationships with internal and external customers.
  • Analytical skills.
  • Ability to travel as needed.
  • Clear and concise verbal and written communication skills.
  • Prior experience coaching staff to enable excellence in customer service and claims management while demonstrating role model behavior.
  • Knowledge of medical terminology
  • Strong financial background (preferred)
  • Fluency in Spanish is highly preferred (preferred)
  • Completion of HIAA, LOMA or ICA courses preferred (preferred)
Responsibilities
  • Contributing to the overall success of departmental objectives by providing timely and accurate support to our client companies and the claims department.
  • Obtain and analyze information in order to make claim decisions and payments on disability claims.
  • Develop and apply appropriate claim and disability management techniques to ensure prompt and accurate payment and liability management of disability claims.
  • Provide responsive customer service to claimants, policyholders, brokers, and internal departments.

HCSC provides health insurance services across five states: Illinois, Montana, New Mexico, Oklahoma, and Texas. The company offers a variety of health insurance plans designed for individuals, families, and businesses, ensuring that different healthcare needs are met. HCSC's plans work by collecting premiums from members, which then fund the healthcare services covered under these plans. What sets HCSC apart from other health insurance providers is its strong focus on health and wellness programs aimed at reducing overall healthcare costs and improving the health outcomes of its members. The goal of HCSC is to be a reliable partner in health, promoting quality care and supporting individuals in leading healthier lives.

Company Stage

N/A

Total Funding

$472.7M

Headquarters

Chicago, Illinois

Founded

N/A

Simplify Jobs

Simplify's Take

What believers are saying

  • The new Houston office will create numerous job opportunities, fostering local economic growth and community development.
  • The acquisition of Cigna's Medicare businesses will expand HCSC's product offerings and geographic reach, benefiting current and future members.
  • Recognition as one of the 'Best Places to Work in IT' and having a CEO listed among the 'Most Influential People in Healthcare' highlight HCSC's strong leadership and positive work environment.

What critics are saying

  • The $231,900 fine from the Illinois Department of Insurance for an inaccurate provider directory could damage HCSC's reputation and trust with members.
  • The integration of Cigna's Medicare businesses may pose operational challenges and potential disruptions.

What makes HCSC unique

  • HCSC's strategic expansion into local communities, such as the new Houston office, emphasizes its commitment to economic growth and local workforce development, setting it apart from competitors.
  • The acquisition of Cigna's Medicare businesses significantly enhances HCSC's capabilities and reach in the growing Medicare market, providing a competitive edge.
  • HCSC's collaboration with Feeding America to address root causes of hunger showcases its holistic approach to community health, beyond traditional healthcare services.

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