claims analyst

Cavya solutions

<p><b>Position Summary: </b>The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which includes validating, verifying, disputing when necessary, and remitting payment for assigned state Medicaid agencies, SPAPs and Supplemental Rebates. Analyst is accountable for submitting payments within deadlines and in compliance with CMS guidelines and rebate contract terms.</p><p>This position also provides assistance in resolving dispute resolution, weekly pay run activities, SOX audits, system upgrade/implementation and ad hoc analysis.</p><p><b>Core Essential Skill sets:</b></p><ul><li>Pharmaceutical experience is a must! Candidate has to quickly join in and start.</li><li>Medicaid rebate experience in pharm environment.</li><li>Prior Medicaid Claim processing experience with a Pharmaceutical and/or med Device company , state and/or state agency or as Medicaid consultant or equivalent work experience</li><li>Minimum 2+ years pharmaceutical/product focused healthcare experience; Medicaid Claim processing function; manipulation of large datasets, negotiation/conflict resolution. System Implementation and report writing.</li><li>Revitas/Flex Medicaid and advance Microsoft Excel skills.</li><li>Strong ability to organize and manipulate large volume of data in various formats. Attention to detail and high degree of accuracy in data processing and reviews.</li></ul><p><b>Essential Duties &amp; Responsibilities Percentage of Time</b></p><ul><li>Work with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each quarter and review to ensure completeness of information received. Upload data into Medicaid systems and authorize transactions. Document errors and perform research.</li></ul><p>Conduct initial quality check on summary data on all claim submissions to ensure rebate eligibility and data consistency. 20%</p><ul><li>Perform Claim Level Detail validation. Review suspect claim records and determines if record should be disputed for payment. 20%</li></ul><ul><li>Resolve disputes and propose recommended amounts to be paid for historical outstanding utilization that is routinely submitted with Medicaid claims. Must have ability to work independently and make recommendation on state disputes, apply proper amounts to be paid &amp; ensure CMS codes are applied correctly; notify states of results/findings. 20%</li></ul><ul><li>Complete Medicaid analyzes and documentation on assigned states/programs. Communicate to manager for key findings and changes to state programs. 10%</li></ul><ul><li>Provide backup for Medicaid team members in any necessary functions and work with team to establish best practices within Medicaid work environment. 5%</li></ul><ul><li>Work with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each quarter and review to ensure completeness of information received. Upload data into Model N / Medicaid systems and authorize transactions. Document errors and perform research 5%</li></ul><ul><li>Conduct initial quality check on summary data on all claim submissions to ensure rebate eligibility and data consistency 5%</li></ul><ul><li>Perform Claim Level Detail validation. Review suspect claim records and determines if record should be disputed for payment. 5%</li></ul><ul><li>Resolve disputes and propose recommended amounts to be paid for historical outstanding utilization that is routinely submitted with Medicaid claims. Must have ability to work independently and make recommendation on state disputes, apply proper amounts to be paid &amp; ensure CMS codes are applied correctly; notify states of results/findings. 5%</li></ul><ul><li>Complete Medicaid analyzes and documentation on assigned states/programs. Communicate to manager for key findings and changes to state programs. 5%</li></ul><p><b>Education Required: </b>Bachelor&rsquo;s degree/ High school Diploma or equivalent combination of experience, training and/or direct work related experience.</p><p><b>Experience Required:</b> Prior Medicaid Claim processing experience with a Pharmaceutical and/or med Device company , state and/or state agency or as Medicaid consultant or equivalent work experience</p><p><b>Experience Preferred:</b> Minimum 2+ years pharmaceutical/product focused healthcare experience; Medicaid Claim processing function; manipulation of large datasets, negotiation/conflict resolution. System Implementation and report writing.</p><p>Specialized or Technical Knowledge, License, Certifications needed: Knowledge of the Model N or Revitas/Flex Medicaid and/or Flex Validata system (or other comparable system) and advance Microsoft Excel skills.</p><p>Familiar with CMS Medicaid rules and state specific issues. Up to date knowledge on Medicaid Validation rules and issues with 340B covered entities.</p><p>Strong ability to organize and manipulate large volume of data in various formats. Attention to detail and high degree of accuracy in data processing and reviews.</p><p><b>Company/Industry Related Knowledge:</b> Medicaid, Government Pricing and Rebate Pharmaceutical industry experience/knowledge prefer.</p><p><b>Travel Requirements:</b> Minimal</p><p><b>Core competencies</b></p><p><b>Analysis</b></p><p>&#61607; Uses good analytical and data interpretation skills to analyze and resolve complex problems</p><p>&#61607; Analyzes processes and systems to improve efficiency and effectiveness through standardization, simplification and automation.</p><p><b>Developing Self and Others</b></p><p>&#61607; Coaches and counsels associates to improve performance toward individual and department goals</p><p>&#61607; Continuously expands technical and personal skills and business knowledge</p><p><b>Interpersonal Ability</b></p><p>&#61607; Develops and fosters strong relationships with internal and external clients</p><p>&#61607; Builds reputation for being credible, trustworthy, and fair</p><p>&#61607; Displays high level of integrity by doing what is right for the company</p><p>&#61607; Demonstrates administrative value to shared service customers</p><p><b>Planning and Organization</b></p><p>&#61607; Committed to meeting deadlines</p><p>&#61607; Demonstrates sense of urgency by effectively prioritizing workload according to organizational needs</p><p>&#61607; Demonstrates the ability to manage multiple priorities</p><p><b>Technical skills</b></p><p>&#61607; Possesses solid accounting skills particularly around accuracy and internal controls</p><p>&#61607; Demonstrates advanced data management and Excel skills</p><p>&#61607; Understands fundamental mechanics of rebate systems</p><p>Job Type: Contract</p><p>Pay: $60.00 - $70.00 per hour</p><p>Expected hours: 40 per week</p><p>Work Location: In person</p>

Medical Claims Analyst

<div>Job Description:<div></div><div><p><br>
Mid-level Ceded Reinsurance Claims Analyst, supporting a global claims portfolio. The role offers proactive ownership, opportunities to work on a wide variety of claims in different lines of business, ongoing professional development (including industry designations), and comprehensive training.</p><h2 class="jobSectionHeader"><b>
What</b><b> </b><b>you&rsquo;ll be doing</b></h2><p>
What will your essential responsibilities include?</p><ul><li>
 Monitor Casualty &amp; Professional claims portfolios and promptly identify and report new or material claim movements requiring notification; manage large-loss diary entries.</li><li>
Adhere to Ceded Claims Best Practices, maintaining an organized diary system for large losses.</li><li>
Review and redact claims narratives as needed to ensure privacy compliance and protection of Attorney-Client Privilege before distribution to reinsurers/brokers</li><li>
Escalate claim disputes or coverage issues to the Ceded Re management and participate in resolution discussions as appropriate.</li><li>
Participate in netting-down exercises for both individual and event losses to determine the Company&rsquo;s ultimate net position.</li><li>
Respond to questions on material claims from outward reinsurers with clear, accurate information.</li><li>
Support management in commutation processes as directed.</li><li>
Facilitate claim audits on assigned books of business, coordinating with internal and external stakeholders.</li></ul><p>
You will report to Lexie Melo, Head of Large Claims, Ceded Re</p><h2 class="jobSectionHeader"><b>
What you&rsquo;ll bring</b></h2><p>
We&rsquo;re looking for someone who has these abilities and skills:</p><p><b>
Required Skills and Abilities:</b></p><ul><li>Direct insurance/claims experience (casualty, professional liability, and/or ceded reinsurance)</li><li>Strong quantitative and analytical abilities</li><li>Proficiency in Microsoft Word, Outlook, and Excel; comfortable learning additional software</li><li>Self-starter with ability to work independently as well as in a distributed/virtual team</li><li>Excellent verbal and written communication skills; ability to convey complex information clearly</li><li>Working knowledge of privacy laws and confidentiality requirements related to claims documentation</li></ul><p><b>
Desired Skills and Abilities:</b></p><ul><li>Preference for experience in US Casualty claims.
</li><li>Familiarity with ceded reinsurance processes, including netting, commutations, and claim audits.</li><li>Interest in pursuing industry designations (e.g., CPCU, ARe) or equivalent professional qualifications.</li><li>Adaptability and innovative problem-solving; readily embraces change and applies creative, practical solutions to evolving challenges.</li></ul></div><h2 class="jobSectionHeader"><b>
What</b><b> </b><b>we</b><b> </b><b>offer</b></h2><div><b>
Inclusion</b></div><div>
AXA XL is committed to equal employment opportunity and will consider applicants regardless of gender, sexual orientation, age, ethnicity and origins, marital status, religion, disability, or any other protected characteristic. At AXA XL, we know that an inclusive culture and enables business growth and is critical to our success. That&rsquo;s why we have made a strategic commitment to attract, develop, advance and retain the most inclusive workforce possible, and create a culture where everyone can bring their full selves to work and reach their highest potential. <i>It&rsquo;s about helping one another &mdash; and our business &mdash; to move forward and succeed.</i></div><br>
<div></div><ul><li>
Five Business Resource Groups focused on gender, LGBTQ+, ethnicity and origins, disability and inclusion with 20 Chapters around the globe.</li><li>
Robust support for Flexible Working Arrangements</li><li>
Enhanced family-friendly leave benefits</li><li>
Named to the Diversity Best Practices Index</li><li>
Signatory to the UK Women in Finance Charter</li></ul><div></div><div><br>
Learn more at axaxl.com/about-us/inclusion-and-diversity. AXA XL is an Equal Opportunity Employer.</div><div></div><div><b><br>
Total Rewards</b></div><div>
AXA XL&rsquo;s Reward program is designed to take care of what matters most to you, covering the full picture of your health, wellbeing, lifestyle and financial security. It provides competitive compensation and personalized, inclusive benefits that evolve as you do.</div><div></div><div><br>
We&rsquo;re committed to rewarding your contribution for the long term, so you can be your best self today and look forward to the future with confidence.</div><div></div><div><b><br>
Sustainability</b></div><div>
At AXA XL, Sustainability is integral to our business strategy. In an ever-changing world, AXA XL protects what matters most for our clients and communities. We know that sustainability is at the root of a more resilient future. Our 2023-26 Sustainability strategy, called &ldquo;Roots of resilience&rdquo;, focuses on protecting natural ecosystems, addressing climate change, and embedding sustainable practices across our operations.</div><div></div><div><br>
Our Pillars:</div><div></div><ul><li><b><br>
Valuing nature: </b>How we impact nature affects how nature impacts us. Resilient ecosystems - the foundation of a sustainable planet and society &ndash; are essential to our future. We&rsquo;re committed to protecting and restoring nature &ndash; from mangrove forests to the bees in our backyard &ndash; by increasing biodiversity awareness and inspiring clients and colleagues to put nature at the heart of their plans.</li><li><b>
Addressing climate change: </b>The effects of a changing climate are far-reaching and significant. Unpredictable weather, increasing temperatures, and rising sea levels cause both social inequalities and environmental disruption. We're building a net zero strategy, developing insurance products and services, and mobilizing to advance thought leadership and investment in societal-led solutions.</li><li><b>
Integrating ESG: </b>All companies have a role to play in building a more resilient future. Incorporating ESG considerations into our internal processes and practices builds resilience from the roots of our business. We&rsquo;re training our colleagues, engaging our external partners, and evolving our sustainability governance and reporting.</li><li><b>
AXA Hearts in Action</b>: We have established volunteering and charitable giving programs to help colleagues support causes that matter most to them, known as AXA XL&rsquo;s &ldquo;Hearts in Action&rdquo; programs. These include our Matching Gifts program, Volunteering Leave, and our annual volunteering day &ndash; the Global Day of Giving.</li></ul><div></div><div><br>
For more information, please see axaxl.com/sustainability.</div><div></div><div><b><br>
Applicants for this role must be legally authorized to work in the United States without sponsorship now or in the future.</b></div><div></div><div><br>
The U.S. base salary range for this position is USD 69,700-94,600.</div><div></div><div><br>
Actual pay will be determined based upon the individual&rsquo;s skills, experience and location. We strive for market alignment and internal equity with our colleagues&rsquo; pay.</div><div></div><div><br>
At AXA XL, we know how important physical, mental, and financial health are to our employees, which is why we are proud to offer benefits such as a competitive retirement savings plan, health and wellness programs, and many other benefits. We also believe in fostering our colleagues' development and offer a wide range of learning opportunities for colleagues to hone their professional skills and to position themselves for the next step of their careers. For more details about AXA XL&rsquo;s benefits offerings, please visit please visit US Benefits at a Glance 2025.</div></div>

Senior Claims Analyst

Med-Metrix

Job Purpose
<br>The Medical Claims Analyst is responsible for collections, account follow up, billing and allowance posting for the accounts assigned to them.
<br><br>
Duties and Responsibilities
<br><ul>
<li>Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites</li>
<li>Meets and maintains daily productivity/quality standards established in departmental policies</li>
<li>Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts</li>
<li>Adheres to the policies and procedures established for the client/team</li>
<li>Knowledge of timely filing deadlines for each designated payer</li>
<li>Performs research regarding payer specific billing guidelines as needed</li>
<li>Ability to analyze, identify and resolve issues causing payer payment delays</li>
<li>Ability to analyze, identify and trend claims issues to proactively reduce denials</li>
<li>Communicates to management any issues and/or trends identified</li>
<li>Initiate appeals when necessary</li>
<li>Ability to identify and correct medical billing errors</li>
<li>Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process</li>
<li>Understanding of under or over payments and credit balance processes</li>
<li>Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required</li>
<li>Act cooperatively and courteously with patients, visitors, co-workers, management and clients</li>
<li>Work independently from assigned work queues</li>
<li>Maintain confidentiality at all times</li>
<li>Maintain a professional attitude</li>
<li>Other duties as assigned by the management team</li>
<li>Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards</li>
<li>Understand and comply with Information Security and HIPAA policies and procedures at all times</li>
<li>Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties</li>
</ul>
Qualifications
<br><ul>
<li>Completed at least High School education</li>
<li>Minimum 1 year of Healthcare Account Receivable/Collections in a BPO setting or environment (claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers)</li>
<li>Experienced on medical billing/ AR Collections</li>
<li>Background in calling insurance (Payer) to verify claim status and payment dispute</li>
<li>Strong interpersonal skills, ability to communicate well at all levels of the organization</li>
<li>Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses</li>
<li>High level of integrity and dependability with a strong sense of urgency and results oriented</li>
<li>Excellent written and verbal communication skills required</li>
<li>Gracious and welcoming personality for customer service interaction</li>
</ul>
Working Conditions
<br><ul>
<li>Must be amenable to work night shifts</li>
<li>Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.</li>
<li>Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.</li>
<li>Work Environment: The noise level in the work environment is usually minimal.</li>
</ul>
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

AXA XL

<ul><li>100 Constitution Plaza, HARTFORD, US, 6103; EXTON</li><li>
RISK MANAGEMENT</li><li>
4415</li><li>
Band B</li><li>
Meghan O'Neill</li></ul>
<br><div><h2 class="jobSectionHeader"><b>Job Description</b></h2><div><div><div><br>
</div><p>Mid-level Ceded Reinsurance Claims Analyst, supporting a global claims portfolio. The role offers proactive ownership, opportunities to work on a wide variety of claims in different lines of business, ongoing professional development (including industry designations), and comprehensive training.</p><h2 class="jobSectionHeader"><b>
What</b><b> </b><b>You&rsquo;ll Be Doing</b></h2><p>
What will your essential responsibilities include?</p><ul><li>
 Monitor Casualty &amp; Professional claims portfolios and promptly identify and report new or material claim movements requiring notification; manage large-loss diary entries.</li><li>
Adhere to Ceded Claims Best Practices, maintaining an organized diary system for large losses.</li><li>
Review and redact claims narratives as needed to ensure privacy compliance and protection of Attorney-Client Privilege before distribution to reinsurers/brokers</li><li>
Escalate claim disputes or coverage issues to the Ceded Re management and participate in resolution discussions as appropriate.</li><li>
Participate in netting-down exercises for both individual and event losses to determine the Company&rsquo;s ultimate net position.</li><li>
Respond to questions on material claims from outward reinsurers with clear, accurate information.</li><li>
Support management in commutation processes as directed.</li><li>
Facilitate claim audits on assigned books of business, coordinating with internal and external stakeholders.</li></ul><p>
You will report to Lexie Melo, Head of Large Claims, Ceded Re</p><h2 class="jobSectionHeader"><b>
What You&rsquo;ll Bring</b></h2><p>
We&rsquo;re looking for someone who has these abilities and skills:</p><p><b>
Required Skills and Abilities:</b></p><ul><li>Direct insurance/claims experience (casualty, professional liability, and/or ceded reinsurance)</li><li>Strong quantitative and analytical abilities</li><li>Proficiency in Microsoft Word, Outlook, and Excel; comfortable learning additional software</li><li>Self-starter with ability to work independently as well as in a distributed/virtual team</li><li>Excellent verbal and written communication skills; ability to convey complex information clearly</li><li>Working knowledge of privacy laws and confidentiality requirements related to claims documentation</li></ul><p><b>
Desired Skills and Abilities:</b></p><ul><li>Preference for experience in US Casualty claims.
</li><li>Familiarity with ceded reinsurance processes, including netting, commutations, and claim audits.</li><li>Interest in pursuing industry designations (e.g., CPCU, ARe) or equivalent professional qualifications.</li><li>Adaptability and innovative problem-solving; readily embraces change and applies creative, practical solutions to evolving challenges.</li></ul></div><h2 class="jobSectionHeader"><b>
What</b><b> </b><b>We</b><b> </b><b>Offer</b></h2><div><b>
Inclusion</b></div><div>
AXA XL is committed to equal employment opportunity and will consider applicants regardless of gender, sexual orientation, age, ethnicity and origins, marital status, religion, disability, or any other protected characteristic. At AXA XL, we know that an inclusive culture and enables business growth and is critical to our success. That&rsquo;s why we have made a strategic commitment to attract, develop, advance and retain the most inclusive workforce possible, and create a culture where everyone can bring their full selves to work and reach their highest potential. <i>It&rsquo;s about helping one another &mdash; and our business &mdash; to move forward and succeed.</i></div><br>
<div></div><ul><li>
Five Business Resource Groups focused on gender, LGBTQ+, ethnicity and origins, disability and inclusion with 20 Chapters around the globe.</li><li>
Robust support for Flexible Working Arrangements</li><li>
Enhanced family-friendly leave benefits</li><li>
Named to the Diversity Best Practices Index</li><li>
Signatory to the UK Women in Finance Charter</li></ul><div></div><div><br>
Learn more at axaxl.com/about-us/inclusion-and-diversity. AXA XL is an Equal Opportunity Employer.</div><div></div><div><b><br>
Total Rewards</b></div><div>
AXA XL&rsquo;s Reward program is designed to take care of what matters most to you, covering the full picture of your health, wellbeing, lifestyle and financial security. It provides competitive compensation and personalized, inclusive benefits that evolve as you do.</div><div></div><div><br>
We&rsquo;re committed to rewarding your contribution for the long term, so you can be your best self today and look forward to the future with confidence.</div><div></div><div><b><br>
Sustainability</b></div><div>
At AXA XL, Sustainability is integral to our business strategy. In an ever-changing world, AXA XL protects what matters most for our clients and communities. We know that sustainability is at the root of a more resilient future. Our 2023-26 Sustainability strategy, called &ldquo;Roots of resilience&rdquo;, focuses on protecting natural ecosystems, addressing climate change, and embedding sustainable practices across our operations.</div><div></div><div><br>
Our Pillars:</div><div></div><ul><li><b><br>
Valuing nature: </b>How we impact nature affects how nature impacts us. Resilient ecosystems - the foundation of a sustainable planet and society &ndash; are essential to our future. We&rsquo;re committed to protecting and restoring nature &ndash; from mangrove forests to the bees in our backyard &ndash; by increasing biodiversity awareness and inspiring clients and colleagues to put nature at the heart of their plans.</li><li><b>
Addressing climate change: </b>The effects of a changing climate are far-reaching and significant. Unpredictable weather, increasing temperatures, and rising sea levels cause both social inequalities and environmental disruption. We're building a net zero strategy, developing insurance products and services, and mobilizing to advance thought leadership and investment in societal-led solutions.</li><li><b>
Integrating ESG: </b>All companies have a role to play in building a more resilient future. Incorporating ESG considerations into our internal processes and practices builds resilience from the roots of our business. We&rsquo;re training our colleagues, engaging our external partners, and evolving our sustainability governance and reporting.</li><li><b>
AXA Hearts in Action</b>: We have established volunteering and charitable giving programs to help colleagues support causes that matter most to them, known as AXA XL&rsquo;s &ldquo;Hearts in Action&rdquo; programs. These include our Matching Gifts program, Volunteering Leave, and our annual volunteering day &ndash; the Global Day of Giving.</li></ul><div></div><div><br>
For more information, please see axaxl.com/sustainability.</div><div></div><div><b><br>
Applicants for this role must be legally authorized to work in the United States without sponsorship now or in the future.</b></div><div></div><div><br>
The U.S. base salary range for this position is USD 69,700-94,600.</div><div></div><div><br>
Actual pay will be determined based upon the individual&rsquo;s skills, experience and location. We strive for market alignment and internal equity with our colleagues&rsquo; pay.</div><div></div><div><br>
At AXA XL, we know how important physical, mental, and financial health are to our employees, which is why we are proud to offer benefits<div>
</div>
such as a competitive retirement savings plan, health and wellness programs, and many other benefits. We also believe in fostering our<div>
</div>
colleagues' development and offer a wide range of learning opportunities for colleagues to hone their professional skills and to position<div>
</div>
themselves for the next step of their careers. For more details about AXA XL&rsquo;s benefits offerings, please visit please visit US Benefits at a Glance 2025.</div></div></div>

<div><p>Job Summary
<br>
Actively manages the freight claim handling process for assigned workload in compliance with Sarbanes-Oxley Act (SOX) requirements, rail carrier liability rules and regulations, transportation contracts, and related company customer consideration practices.
</p><div>Primary Activities and Responsibilities
<br>
<ul><li>Investigate assigned claims under rail carrier liability rules, regulations, freight claim rules, and contracts.
</li><li>Gather and analyze all facts to determine a fair settlement (whether declined or payable).
</li><li>Process claim review and settlements in Channel Revenue Management system and upload all supporting documentation for review and a final approval by management.
</li><li>Provide updates and supporting documentation to validate claim resolution decisions via claimant's third party vendor sites.
</li><li>Prompt review and resolution of all claim disputes and reconsideration.
</li><li>Issue third party contractor bills to responsible party and provide electronic packets to support billing and collections as needed by the Damage Prevention team.
</li><li>Responsible for handling the entire billing process from creation to final collection.
</li><li>Investigate and resolve recharged claims from foreign line carriers promptly and communicate with sales and marketing managers on liability issues as needed.
</li><li>Miscellaneous activities and responsibilities as assigned by manager
</li></ul>Minimum Qualifications
<br>
<ul><li>Bachelor's Degree/4-year Degree
</li><li>1 or more years of experience in Business/Strategic Management, Sales/Account Management, Marketing, Accounting, Finance, Transportation, Logistics, Supply Chain, Operations or related major field
</li></ul>Preferred Qualifications
<br>
<ul><li>Bachelor's Degree/4-year Degree
</li><li>3 or more years of experience in Managing claims or investigative work
</li></ul>Knowledge and Skills
<br>
<ul><li>Knowledge of liability provisions of transportation contracts and related coverage laws
</li><li>Knowledge of freight liability
</li><li>Oracle - Oracle web based fluency and BOBJ reports
</li><li>INFOPAC
</li><li>Legacy system knowledge
</li><li>Advanced level of investigation techniques and familiarity with liability provisions and related coverage laws.
</li><li>Ability to maintain daily/weekly production quota levels with a high degree of accuracy
</li><li>Work under pressure and maintain composure while handling multiple responsibilities.
</li><li>Strong sense of urgency, attention to detail and ability to meet short deadlines.
</li><li>Excellent verbal and written communication, negotiation, and presentation skills
</li></ul>Leadership
<br>
The CSX Leadership Model is the foundation of our Talent Strategy and is what drives CSX performance. CSX accordingly selects and develops talent based on each of the following: producing results, creating change, and inspiring excellence.
</div><div>Job Requirements
<br>
<ul><li>Work hours may vary in length and schedule (may include a non-standard work week)</li></ul></div></div><p></p>

Freight Claims Analyst

State of Florida

<div><p>Requisition No: 863335</p>
<p>Agency: Office of the Attorney General</p>
<p>Working Title: VICTIM COMPENSATION CLAIMS ANALYST - 41000638</p>
<p> Pay Plan: Career Service</p>
<p>Position Number: 41000638</p>
<p>Salary: $42,024.32</p>
<p>Posting Closing Date: 11/13/2025</p>
<p><b>Total Compensation Estimator </b><b>Tool</b></p>
<div><b>
Our Organization and Mission:</b><b> </b>The Office represents the State of Florida in state and federal civil and criminal courts, from trial courts to the Supreme Court of the United States.</div><br>
<div></div>
<p><b>
Pay</b><b>:</b><b> $</b><b>42,024.32</b><b> Annually</b></p><br>
<div>
</div><div><b>Position Summary:</b> The incumbent in this position serves the primary role of processing claim and payment determinations in the Bureau of Victim Compensation and plays an integral role in the overall effectiveness and efficiency of the program through daily activities in the claims process.</div><br>
<div></div>
<div><b>
Qualifications:</b></div><br>
<div></div>
<ul>
<li>Three (3) years of relevant clerical or administrative experience in the areas of: accounting; claims processing; claims or benefits eligibility determination; social or victim services; disability examiner; claims adjuster; insurance adjuster; or case manager processing eligibility and benefit payments.</li>
<li>A bachelor's degree from an accredited college or university can substitute for required work experience.
</li><li>A high school diploma (or equivalent) can substitute for one year of required work experience.</li></ul><br>
<div></div>
<div><b>
The Work You Will Do:</b><b> </b>This position&rsquo;s duties include but not limited to the following:</div><br>
<div>
</div><ul><li>Resolve compensability issues and independently determine eligibility for victim compensation benefits in accordance with established statutes, administrative rules, and procedures within two business days of receipt and with no margin of error. If necessary, generate requests for information and utilize correspondence from victims, applicants, attorneys, centers, financial institutions, insurance carriers, medical providers, and/or criminal justice agencies to finalize determinations.</li>
<li>Perform criminal history background checks for victims and applicants seeking victim compensation and/or property loss benefits using the Criminal Justice Information System, with no margin of error.</li>
<li>Contact law enforcement and criminal justice entities concerning claims to assess statutory elements of eligibility for benefits, as well as obtain information regarding the status of prosecution and restitution.</li>
<li>Contact victims telephonically to provide an introduction, status information, and/or instructions within two business days of claim assignment.</li>
<li>Contact vendors, advocates, employers, treatment providers, contractors, and/or collateral sources to verify costs directly related to the criminal victimization, and to verify that collateral sources are exhausted prior to payment by the trust fund, if applicable. Authorize payments in accordance with established statutes, administrative rules, and procedures. Identify potential subrogation activities, and handle refund/recoupment/restitution issues as needed.</li>
<li>Respond to inquiries and concerns received via telephone, email, fax, or mail, within two business days of receipt.
</li><li>Communicate effectively both orally and in writing by providing information that is professional, clear and well understood. Resolve problems and complaints without escalation and with minimal referral to supervisors. Demonstrate sensitivity and awareness while adhering to confidentiality practices.
</li><li>Recognize obligations in the transparency of public records laws to record activities in a concise and impartial manner.</li>
<li>Perform Automated Call Distribution duties as needed.</li>
<li>Based on monthly statistical reports, achieve quantitative measurements of aptitude no less than 50 claim determinations processed, and 30 expenses paid monthly.</li>
<li>Finalizes quality assurance corrective actions within five business days of notification.</li>
<li>Complete special projects as requested and finalize directives within established time frames.</li></ul><br>
<p></p>
<p>
Note: This position may require extended hours and/or travel outside of the work site.</p><br>
<div></div>
<div><b>
Candidate Profile (application) must be completed in its entirety.</b></div>
<ul>
<li>Include supervisor names and phone numbers for all periods of employment.</li>
<li>Account for and explain any gaps in employment so that the hiring process is not delayed.</li>
<li>Experience, education, training, knowledge, skills and/or abilities as well as responses to pre-qualifying questions must be verifiable to meet the minimum qualifications.</li>
<li>It is unacceptable to use the statement &ldquo;See Resume&rdquo; in place of entering work history.</li>
<li><b>If you experience problems applying online, please call the People First Service Center at (877) 562-7287.</b></li></ul><br>
<div></div>
<div><b>
The Benefits of Working for the State of Florida:</b><b> </b>Working for the State of Florida is more than a paycheck. The State&rsquo;s total compensation package for employees features a highly competitive set of employee benefits including:</div>
<ul>
<li>Annual and Sick Leave benefits.</li>
<li>Nine paid holidays and one Personal Holiday each year.</li>
<li>State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options.</li>
<li>Retirement plan options, including employer contributions (For more information, please click www.myfrs.com).</li>
<li>Flexible Spending Accounts</li>
<li>Tuition waivers.</li>
<li>And more! For a more complete list of benefits, visit www.mybenefits.myflorida.com.</li></ul><br>
<p></p>
<div><b>
IMPORTANT NOTICE:</b> To be considered for the position, all applicants must:</div>
<div><b>
Submit a complete and accurate application profile necessary for qualifying such as dates of service, reason for leaving, etc. In addition, all applicants must ensure all employment and/or detailed information about work experience is listed on the application (including military service, self-employment, job-related volunteer work, internships, etc.) and that gaps in employment are explained. </b><b>NOTE:</b><b> Any required experience and/or preferences listed in the advertisement must be verified at the time of application.</b></div>
<ul>
<li>Ensure that applicant responses to qualifying questions are verifiable by skills and/or experience stated on the employment application and/or resume. Applicants who do not respond to the qualifying questions will not be considered for this position.</li>
<li>The elements of the selection process may include a skill assessment exercise.</li>
<li>Current and future vacancies may be filled from this advertisement for a period of up to six months. Following the six-month period, a new application must be submitted to an open advertisement to be considered for that vacancy.</li>
<li>OAG employees are paid biweekly. All state employees are required to participate in the direct deposit program pursuant to s. 110.113, F.S.</li></ul><br>
<p></p>
<div>
 <b>CRIMINAL BACKGROUND CHECKS/ DRUG FREE WORKPLACE:</b><b> </b>All OAG positions are &quot;sensitive or special trust&quot; and require favorable results on a background investigation including fingerprinting, pursuant to s. 110.1127(2)(a), F.S. The State of Florida supports a Drug-Free Workplace, all employees are subject to reasonable suspicion or other drug testing in accordance with section 112.0455, F.S., Drug-Free Workplace Act. We hire only U.S. citizens and those lawfully authorized to work in the U.S.</div><br>
<div></div>
<div><b>
E-VERIFY STATEMENT:</b><b> </b>The Office of the Attorney General participates in the U.S. government&rsquo;s employment eligibility verification program (E-Verify). E-Verify is a program that electronically confirms an employee&rsquo;s eligibility to work in the United States after completion of the employment eligibility verification form (i-9).</div><br>
<div></div>
<div><b>
PERSONS WITH DISABILITY/ADA STATEMENT:</b> The OAG supports the employment of individuals with disabilities and encourages them to seek employment within our agency. If you need an accommodation because of a disability, as defined by the Americans with Disabilities Act, in order to participate in the application process, please notify the people first service center at 877-562-7287. If you need accommodation during the selection process, please notify the hiring authority in advance to allow sufficient time to provide accommodation.</div><br>
<div></div>
<div><b>
REMINDERS:</b><b> </b>Male applicants born on or after October 1, 1962, will not be eligible for hire or promotion unless they are registered with the Selective Service System (SSS) before their 26th birthday, or have a Letter of Registration Exemption from SSS. For more information, please visit the SSS website at: https: //www.sss.gov. If you are a retiree of the Florida Retirement System (FRS), please check with the FRS on how your current benefits will be affected if you are re-employed with the State of Florida. If you return to FRS employment before satisfying the required waiting period, your retirement may be voided, and you may have to repay all benefits you have received, including any Deferred Retirement Option Program (DROP) payout.</div><br>
<p>
</p><p>The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.</p>
<p>Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.</p>
<p>The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.</p>
<p><b>VETERANS&rsquo; PREFERENCE. </b>Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans&rsquo; Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements. Candidates claiming Veterans&rsquo; Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans&rsquo; Preference documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement.</p></div>

VICTIM COMPENSATION CLAIMS ANALYST

Resmed

<div><p><b>Let&rsquo;s talk about the team and you
</b></p><p></p><p>We&rsquo;re looking for a motivated and personable <b>Claims Enrollment Analyst </b>to join our Corporate team.
</p><p></p><p>If you enjoy working with clients, learning new software, and solving problems, this role offers the opportunity to make a real impact. You&rsquo;ll collaborate with Implementation Project Managers, Software Support Analysts, and third-party vendors to ensure a smooth and efficient enrollment process for our clients.
</p><p>This role is ideal for someone who enjoys balancing independent work with teamwork, has strong attention to detail, and thrives on finding solutions. You&rsquo;ll be working with data, technology, and people&mdash;connecting the dots that keep claims and remittance processes running seamlessly.
</p><p></p><p>We provide comprehensive training for this position, so curiosity, adaptability, and a drive to learn are key.
</p><h3 class="jobSectionHeader"><b>Let&rsquo;s talk about responsibilities
</b></h3><ul><li><p>Conduct needs assessments with clients to determine the appropriate claims and remit enrollment process.
</p></li><li><p>Build and configure Claims Management site setups to support client onboarding.
</p></li><li><p>Guide clients through payer enrollment requirements to ensure a smooth and compliant process.
</p></li><li><p>Collaborate with internal project teams to address client needs and additional setup requirements.
</p></li><li><p>Keep clients informed about payer-related issues that could impact billing timelines.
</p></li><li><p>Troubleshoot enrollment issues in coordination with project teams and payers.
</p></li><li><p>Partner with payers to ensure regulatory changes are communicated and implemented effectively.
</p></li><li><p>Establish and test new payer connectivity in coordination with the clearinghouse.
</p></li><li><p>Escalate issues with clearinghouse partners as needed to ensure timely resolution.
</p></li></ul><p></p><h3 class="jobSectionHeader"><b>Let&rsquo;s talk about qualifications
</b></h3><ul><li><p>Typically 0&ndash;2 years of experience in billing, claims, or insurance processing.
</p></li><li><p>Strong computer navigation and data management skills; comfort working with electronic files and systems.
</p></li><li><p>Proven ability to learn new software and processes quickly.
</p></li><li><p>Excellent communication, problem-solving, and client service skills.
</p></li><li><p>Ability to work independently while collaborating effectively within a team environment.
</p></li><li><p>Bachelor&rsquo;s degree in <b>Education, Business, Accounting, Nursing, or a related healthcare field </b>is preferred.
</p></li></ul><p></p><h3 class="jobSectionHeader"><b>Let&rsquo;s talk about what you can expect
</b></h3><ul><li><p>A collaborative and supportive work environment that values learning and continuous improvement.
</p></li><li><p>Comprehensive training to help you build expertise in healthcare technology and claims operations.
</p></li><li><p>Opportunities to work with cross-functional teams and expand your professional skills.
</p></li><li><p>A workplace that values curiosity, accuracy, and a customer-first mindset.
</p></li></ul><p></p><p>Joining us is more than saying &ldquo;yes&rdquo; to making the world a healthier place. It&rsquo;s discovering a career that&rsquo;s challenging, supportive and inspiring. Where a culture driven by excellence helps you not only meet your goals, but also create new ones. We focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace and thrive on the innovative ideas this generates. If this sounds like the workplace for you, apply now! We commit to respond to every applicant.</p></div><p></p>

Claims Enrollment Analyst

Search 6518+ Claims analyst jobs near you this November. New roles added regularly across leading industries. Apply today.

6518 claims analyst jobs NEAR_ME

Medical Claims Analyst

Senior Claims Analyst

Medical Claims Analyst

Senior Claims Analyst

Freight Claims Analyst

VICTIM COMPENSATION CLAIMS ANALYST

Claims Enrollment Analyst