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Claims Analyst

Company Description

We help the world see new possibilities and inspire change for better tomorrows. Our analytic solutions bridge content, data, and analytics to help business, people, and society become stronger, more resilient, and sustainable.

Job Description

We are seeking a Claims Analyst for our Allocation Solutions Department. In this role you will be responsible for file intake and set up of all Medicare Secondary Payer (MSP) products, full review, analysis and response to submission requests and development letters, information and documentation follow-up, and client communication. The Claims Analyst role is heavily client facing and each Claims Analyst is responsible for successful communication, timely responses and providing overall excellent customer service. If you thrive in a fast-paced environment that emphasizes individual accountability with the support of a team structure, come join us!

About the Day to Day Responsibilities of the Role

  • Intake incoming referrals into claims system, including initial follow-up for incomplete referrals for missing information
  • Comprehensive review, analysis and response to CMS submission requests, development letters and all other communication received from CMS and/or their contractors
  • Serve as primary point of contact for assigned clients
  • Communicate effectively, timely and comprehensively. Communication includes, but is not limited to, internal emails, client inquiries, case status requests, case updates and general subject matter questions

Qualifications

About You and How You Can Excel in This Role

  • Detail-oriented, organized, and quality focused 
  • Advanced customer service and communication skills, both verbal and written
  • Excellent technical skills and working knowledge of Microsoft Office
  • Able to work independently, self-directed, highly motivated
  • Desire to work in a fast-paced, professional environment
  • Flexible and adaptable
  • 1-2 years’ experience
  • Associate’s or bachelor’s degree preferred

#LILO1

Additional Information

For over 50 years, Verisk has been the leading data analytics and technology partner to the global insurance industry by delivering value to our clients through expertise and scale. We empower communities and businesses to make better decisions on risk, faster.

At Verisk, you'll have the chance to use your voice and build a rewarding career that's as unique as you are, with work flexibility and the support, coaching, and training you need to succeed. 

For the eighth consecutive year, Verisk is proudly recognized as a Great Place to Work® for outstanding workplace culture in the US, fourth consecutive year in the UK, Spain, and India, and second consecutive year in Poland.  We value learning, caring and results and make inclusivity and diversity a top priority.  In addition to our Great Place to Work® Certification, we’ve been recognized by The Wall Street Journal as one of the Best-Managed Companies and by Forbes as a World’s Best Employer and Best Employer for Women, testaments to the value we place on workplace culture.

We’re 7,000 people strong.  We relentlessly and ethically pursue innovation. And we are looking for people like you to help us translate big data into big ideas. Join us and create an exceptional experience for yourself and a better tomorrow for future generations.

 

Verisk Businesses

Underwriting Solutions — provides underwriting and rating solutions for auto and property, general liability, and excess and surplus to assess and price risk with speed and precision

Claims Solutions — supports end-to-end claims handling with analytic and automation tools that streamline workflow, improve claims management, and support better customer experiences

Property Estimating Solutions — offers property estimation software and tools for professionals in estimating all phases of building and repair to make day-to-day workflows the most efficient

Extreme Event Solutions — provides risk modeling solutions to help individuals, businesses, and society become more resilient to extreme events.

Specialty Business Solutions — provides an integrated suite of software for full end-to-end management of insurance and reinsurance business, helping companies manage their businesses through efficiency, flexibility, and data governance

Marketing Solutions — delivers data and insights to improve the reach, timing, relevance, and compliance of every consumer engagement

Life Insurance Solutions – offers end-to-end, data insight-driven core capabilities for carriers, distribution, and direct customers across the entire policy lifecycle of life and annuities for both individual and group.

Verisk Maplecroft — provides intelligence on sustainability, resilience, and ESG, helping people, business, and societies become stronger

Verisk Analytics is an equal opportunity employer.

All members of the Verisk Analytics family of companies are equal opportunity employers. We consider all qualified applicants for employment without regard to race, religion, color, national origin, citizenship, sex, gender identity and/or expression, sexual orientation, veteran's status, age or disability.

http://www.verisk.com/careers.html

Unsolicited resumes sent to Verisk, including unsolicited resumes sent to a Verisk business mailing address, fax machine or email address, or directly to Verisk employees, will be considered Verisk property. Verisk will NOT pay a fee for any placement resulting from the receipt of an unsolicited resume.

 HR CCPA Privacy Notice.pdf

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What You Should Know About Claims Analyst, Verisk

Join Verisk in Bradenton, FL as a Claims Analyst and become a vital part of our Allocation Solutions Department! If you have a passion for data and analytics and enjoy client interaction, this role could be a perfect fit for you. As a Claims Analyst, you will manage the intake and setup of all Medicare Secondary Payer (MSP) products. Your day-to-day responsibilities will include reviewing and analyzing submission requests from the Centers for Medicare & Medicaid Services (CMS) and crafting thorough responses. You'll also be responsible for following up on documentation and maintaining clear communication with clients. Our ideal candidate thrives in a fast-paced environment and enjoys delivering high-quality customer service. You'll build strong relationships with clients and serve as their go-to expert, providing timely responses and updates on their cases. It's all about collaboration and accountability, so expect a supportive team that values your contributions. We are looking for someone who is detail-oriented, organized, and has top-notch communication skills both verbally and in writing. With 1-2 years of experience and ideally a degree under your belt, you'll be set to excel in this role. At Verisk, we pride ourselves on being a Great Place to Work, and we’re dedicated to not only empowering our clients but also our employees. If you're ready to inspire change and make a difference in the world through data, apply to become a Claims Analyst today!

Frequently Asked Questions (FAQs) for Claims Analyst Role at Verisk
What are the responsibilities of a Claims Analyst at Verisk in Bradenton, FL?

As a Claims Analyst at Verisk, your primary responsibilities will include the intake and setup of Medicare Secondary Payer (MSP) products, conducting comprehensive reviews of CMS submission requests, and maintaining communication with clients about case status updates. You'll also need to follow up on incomplete referrals and ensure excellent customer service is delivered consistently.

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What qualifications are required for the Claims Analyst position at Verisk?

To be considered for the Claims Analyst role at Verisk, candidates should have 1-2 years of relevant experience and ideally hold an Associate’s or Bachelor's degree. Important skills include strong attention to detail, advanced customer service abilities, and proficient technical skills, particularly in Microsoft Office.

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What makes Verisk a great place to work for Claims Analysts?

Verisk has been recognized as a Great Place to Work due to its commitment to creating an inclusive workplace culture. As a Claims Analyst, you will enjoy support, coaching, and ongoing training, enabling you to thrive in your career. The company values results, learning, and caring, offering flexibility and diverse opportunities for professional growth.

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How does the Claims Analyst role at Verisk involve client communication?

In the Claims Analyst role at Verisk, you will be the primary point of contact for assigned clients. Effective communication is key, as you will need to respond to inquiries about case status, provide updates, and handle any subject matter questions clients may have. Your goal will be to foster strong relationships through timely and comprehensive responses.

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What skills are essential for success as a Claims Analyst at Verisk?

Successful Claims Analysts at Verisk should possess excellent organizational skills, a strong eye for detail, and a commitment to quality. Additionally, advanced verbal and written communication skills are essential for effectively managing client relationships and responding to CMS-related inquiries.

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Is prior experience in claims processing necessary for the Claims Analyst position at Verisk?

While prior experience in claims processing can be beneficial, Verisk is open to candidates with a solid foundation in customer service and a willingness to learn. The company values diverse backgrounds and encourages applicants who are detail-oriented and tech-savvy to apply.

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What advancement opportunities are available for Claims Analysts at Verisk?

At Verisk, we believe in nurturing talent and providing employees with career development opportunities. As a Claims Analyst, you can pursue various paths within the company, including roles in data analytics, project management, or specialized claims processing teams, based on your interests and aspirations.

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Common Interview Questions for Claims Analyst
Can you explain the Medicare Secondary Payer program and its importance?

In your response, provide an overview of the Medicare Secondary Payer program, emphasizing its role in determining which insurance pays first when a Medicare beneficiary has other coverage. Highlight how understanding this program will allow you to manage claims more effectively.

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How do you ensure accuracy and compliance in your claims submissions?

Explain your strategies for maintaining accuracy, such as conducting thorough reviews of documentation, utilizing checklists, and keeping up to date with CMS guidelines. Mention the importance of attention to detail in preventing costly errors.

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Describe a time when you had to handle a difficult client situation as a Claims Analyst.

Share a specific example of a challenging client interaction and how you resolved it. Focus on your communication skills, ability to listen actively, and your methods for defusing tension and building rapport.

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What tools or systems have you used for claims analysis and management?

List relevant software or case management systems you’ve used in your previous roles. Explain how you used these tools for data entry, workflow management, or claims tracking, and emphasize your proficiency in Microsoft Office.

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How do you prioritize tasks when managing multiple claims?

Discuss your approach to prioritization, such as using a task management system, assessing deadlines, and determining the complexity of claims. Share examples of how you more effectively manage your workload in a fast-paced environment.

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What strategies would you employ to follow up on incomplete referrals?

Describe your process for tracking incomplete referrals, how you communicate with parties involved to gather the missing information, and your approach to ensuring follow-up actions are timely and organized.

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How do you stay updated on changes in healthcare regulations and policies related to claims?

Mention how you engage in continuous learning through online resources, webinars, or professional associations. Highlight your proactive approach to keeping abreast of relevant changes that could impact your work.

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Can you detail your experience working with CMS or similar organizations?

Share your experience interacting with CMS or related bodies, focusing on how that experience has shaped your understanding of claims processes and your ability to navigate complex regulations.

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How would you handle a missed deadline for a claims submission?

Discuss a realistic plan for addressing missed deadlines, including immediate communication with stakeholders, identifying the reasons for the delay, and implementing corrective actions to prevent future occurrences.

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Why do you want to work as a Claims Analyst at Verisk?

Express your enthusiasm for the role and the company. Discuss how Verisk’s commitment to innovation and its recognized workplace culture aligns with your professional goals and values. Mention your eagerness to contribute to the team.

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To be the leading strategic data, analytics and technology partner to the global insurance industry by delivering value to our clients through knowledge, expertise and scale.

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Full-time, on-site
DATE POSTED
November 28, 2024

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