medical claims analyst

Acrisure LLC

<div><h2 class="jobSectionHeader">Job Description</h2>
About Acrisure 
A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services, and more.
In the last twelve years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries. Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible.
JOB SUMMARY
Acrisure is seeking a Claims Analyst II to manage multi-state workers&rsquo; compensation claims, including indemnity, employer&rsquo;s liability, and subrogation exposures. This role is responsible for independently handling claims from assignment through resolution, ensuring timely, accurate, and compliant claim outcomes.
The Claims Analyst II will evaluate coverage, determine compensability, manage litigation, and coordinate all aspects of the claims process. This position is well suited for an experienced claims professional who is comfortable working in a fast paced environment and managing multiple files with a high level of autonomy.
Responsibilities<ul><li>
Manage a caseload of multi-state workers&rsquo; compensation claims, including indemnity, employer&rsquo;s liability, and subrogation exposures</li><li>
Conduct initial claim investigation, including coverage verification, compensability determination, and timely contact with involved parties</li><li>
Communicate with injured workers, employers, medical providers, attorneys, and other stakeholders to support claim resolution</li><li>
Set and manage reserves to ultimate probable cost within established authority levels</li><li>
Ensure timely delivery of benefits and required notices in accordance with jurisdictional requirements</li><li>
Coordinate return to work efforts in alignment with medical guidance and employer programs</li><li>
Manage litigation, including directing defense counsel and attending hearings or depositions as needed</li><li>
Negotiate settlements with injured workers, attorneys, and other parties</li><li>
Identify and pursue subrogation opportunities and manage third party recoveries</li><li>
Review medical and expense bills for accuracy, causation, and appropriateness</li><li>
Maintain accurate and timely documentation within the claims system</li><li>
Prepare claim status reports and participate in claim review meetings</li><li>
Assign and coordinate nurse case management resources when appropriate</li><li>
Collaborate with leadership on complex claims requiring additional support or escalation</li></ul>
Requirements<ul><li>
Experience handling workers&rsquo; compensation claims required</li><li>
2 to 5 years of relevant claims experience or equivalent experience required</li><li>
Strong understanding of workers&rsquo; compensation laws, claims processes, and jurisdictional requirements</li><li>
Experience managing indemnity claims, litigation, and claim resolution strategies</li><li>
Strong analytical skills, decision making ability, and attention to detail</li><li>
Strong communication and negotiation skills</li><li>
Ability to manage multiple claims in a fast paced environment</li><li>
Strong organizational and time management skills</li><li>
Proficiency with Microsoft Office and claims management systems</li><li>
Ability to work independently with limited supervision</li><li>
Litigation experience beneficial</li></ul>
Education and Licenses<ul><li>
High school diploma required, bachelor&rsquo;s degree beneficial</li><li>
Relevant state licensing beneficial or ability to obtain as required</li></ul>
Pay Details:
The base compensation range for this position is $60,000 - $71,050. This range reflects Acrisure's good faith estimate at the time of this posting. Placement within the range will be based on a variety of factors, including but not limited to skills, experience, qualifications, location, and internal equity.
Candidates should be comfortable with an on-site presence to support collaboration, team leadership, and cross-functional partnership. 
Why Join Us:
At Acrisure, we&rsquo;re building more than a business, we&rsquo;re building a community where people can grow, thrive, and make an impact. Our benefits are designed to support every dimension of your life, from your health and finances to your family and future.
Making a lasting impact on the communities it serves, Acrisure has pledged more than $22 million through its partnerships with Corewell Health Helen DeVos Children's Hospital in Grand Rapids, Michigan, UPMC Children's Hospital in Pittsburgh, Pennsylvania and Blythedale Children's Hospital in Valhalla, New York. 
Employee Benefits
We also offer our employees a comprehensive suite of benefits and perks, including:<ul><li>
Physical Wellness: Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time.</li><li>
Mental Wellness: Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription.</li><li>
Financial Wellness: Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs.</li><li>
Family Care: Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage.</li><li>
&hellip; and so much more!</li></ul>
This list is not exhaustive of all available benefits. Eligibility and waiting periods may apply to certain offerings. Benefits may vary based on subsidiary entity and geographic location. 
Acrisure is an Equal Opportunity Employer. We consider qualified applicants without regard to race, color, religion, sex, national origin, disability, or protected veteran status. Applicants may request reasonable accommodation by contacting leaves@acrisure.com.
Final candidates will be required to complete post-offer verification processes related to the role and in accordance with applicable laws. 
California Residents: Learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy. 
Recruitment Fraud: Please visit here to learn more about our Recruitment Fraud Notice. 
Welcome, your new opportunity awaits you.</div>

Claims Analyst II

The Hartford

<div>Sr Claims Analyst FL - CV08DE
We&rsquo;re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals &ndash; and to help others accomplish theirs, too. Join our team as we help shape the future. 
The Global Financial Lines Senior Claims Analyst - Allied Health Professional Liability manages complex primary and excess financial lines claims under claims‑made policies. This role applies strong technical expertise and sound judgment to evaluate, manage, and resolve claims in accordance with company standards and regulatory requirements.
Job duties include:
Claim File Management<ul><li>
Plan, recommend, reserve, and execute file strategies including investigation, valuation, disposition, and settlement of assigned claims of low to moderate exposure and/or complexity, in a manner consistent with corporate claim settlement policies and procedures, and statutory, regulatory and ethics requirements</li><li>
Appropriately escalate matters to Team Lead/management per escalation protocols</li><li>
Independently draft and issue timely reservation of rights letters on all files and independently draft denials for management review</li><li>
Properly assesses the exposure of assigned claims. Plan and organize, establish priorities, anticipate issues, determine realistic completion dates, know and communicate the status of assignments, appropriately manage vendors</li><li>
Demonstrate increasing ability and continued development with respect to appropriately interpreting and applying financial lines insurance coverage concepts, including how to trigger other insurance when indicated</li><li>
Demonstrate development regarding technical and jurisdictional expertise</li><li>
Maintain current knowledge of claim loss cost management initiatives, and utilize them appropriately and in a manner consistent with company practices and procedures</li><li>
Identify and properly utilize mitigation, subrogation, and other recovery opportunities</li></ul>
Customer Service<ul><li>
Maintain dedication to meeting or exceeding expectations and requirements of internal and external customers</li><li>
Obtain first-hand customer information; use it for improvements in products and services</li><li>
Establish and maintain effective relationships with customers, gaining their trust and respect. Demonstrate diplomacy and tact to effectively avoid or diffuse high-tension situations.</li></ul>
Business Acumen and Technical Expertise<ul><li>
Utilize verbal and numerical critical thinking skills to gather information, apply sound reasoning, and draw appropriate conclusions; make sound decisions based upon mixture of analysis, experience, and judgment.</li><li>
Accurately resolve coverage and compensability issues.</li><li>
Demonstrated experience investigating, evaluating, and successfully negotiating/mediating claims to appropriate disposition.</li><li>
Possess superior analytical and critical thinking skills.</li><li>
Excellent time management abilities</li><li>
Possess the technical knowledge to properly reserve claims</li><li>
Properly apply statutory laws and regulations of applicable jurisdiction</li><li>
Demonstrate advanced expertise to utilize claim management practices to effectively manage loss costs</li><li>
Contribute to loss cost management by recognizing potential for Subrogation and Special Investigation</li></ul>
Teamwork and Team Building<ul><li>
Support and help create a team environment that celebrates diversity and Inclusion</li><li>
Support and assist in building a high performing team with diverse characteristics, where individual differences are valued</li><li>
Build appropriate rapport and constructive and effective relationships with people inside and outside the organization</li><li>
This position will handle files in more than one claims systems</li></ul>
Qualifications<ul><li>
College degree required, J.D. strongly preferred</li><li>
At least two to three years of successful relevant experience handling third-party professional liability claims or litigation, with a career history of increasing responsibility</li><li>
Experience handling allied health or medical malpractice matters strongly preferred</li><li>
Technical expertise in managing claims</li><li>
Self-starter, resourceful and independent</li><li>
Ability to work in a fast-paced environment and ability to prioritize work</li><li>
Outside the box thinking to negotiate creative resolutions</li><li>
Strong computer proficiency in utilizing software programs, knowledge of ECOS claim system a plus</li><li>
Strong communication skills, oral, written, collaboration and negotiation</li><li>
Excellent time management and organizational skills</li><li>
Superior customer service skills</li><li>
Adept at managing conflict as an opportunity to listen and share information while negotiating a win/win outcome that supports The Hartford's and the insured&rsquo;s best interests</li><li>
State adjusting licenses will be required; a plus if already obtained</li><li>
Proficiency in using Microsoft Word and Excel</li><li>
Operate under the mindset of The Hartford's Behaviors: be courageous, break through, and better the experience</li></ul>
This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office locations (Hartford, CT, San Antonio, TX, Lake Mary, FL, Phoenix, AZ, Naperville, IL, Alpharetta, GA) will have the expectation of working in an office 3 days a week (Tuesday through Thursday). Candidates who do not live near an office will have a remote work arrangement, with the expectation of coming into an office as business needs arise.
Compensation
The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford&rsquo;s total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:
$108,800 - $163,200
Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age</div>

Senior Claims Analyst - Allied Health Professional Liability

South Central Regional Medical Center

<div>Epic Billing Claims &amp; Electronic Remittance Analyst &ndash; Job Description
Position Summary
The Epic Billing Claims and Electronic Remittance Analyst is responsible for the design, build, optimization, and support of Epic Revenue Cycle functionality related to claims submission, remittance advice (ERA), and payer connectivity. This role partners closely with Revenue Cycle, Patient Financial Services, IT, and external payers to ensure accurate, timely billing and reimbursement while supporting continuous optimization and regulatory compliance.
Application Build &amp; Configuration<ul><li>
Configure, support, and optimize Epic Billing Claims, Electronic Remittance (ERA), and related Revenue Cycle workflows.</li><li>
Build and maintain claim formats, payer edits, remittance routing, adjustment reason codes and posting logic.</li><li>
Support clearinghouse integrations and payer connectivity.</li><li>
Configure and troubleshoot ANSI X12 transactions (837, 835, 276/277, 999).</li><li>
Maintain payers-specific rules, claim edits, and remittance mapping.</li></ul>
Claims &amp; Remittance Operations<ul><li>
Troubleshoot claim rejections, denials and remittance posting issues.</li><li>
Analyze payer responses and identify root causes of claim failures or posting discrepancies.</li><li>
Support electronic payment posting, secondary billing and reconciliation processes.</li><li>
Partner with billing and follow-up teams to improve first-pass claim acceptance and payment accuracy.</li></ul>
Optimization &amp; Reporting<ul><li>
Participate in optimization initiatives to improve claims throughput, reimbursement accuracy and cash flow.</li><li>
Analyze workflows and recommend system enhancements aligned with Epic best practices.</li><li>
Develop and maintain reports and dashboards related to claims status, remittance posting and payer performance.</li><li>
Support system upgrades, patches and new Epic functionality related to billing and remittance.</li></ul>
Collaboration &amp; Governance<ul><li>
Collaborate with operational stakeholders, payers, clearinghouses, and vendor partners.</li><li>
Participate in governance groups, optimization committees, and project workgroups.</li><li>
Assist with testing (unit, integrated, and user acceptance testing) for Revenue Cycle changes.</li><li>
Provide end-user training, documentation, and ongoing support.</li></ul>
Compliance &amp; Quality<ul><li>
Ensure Epic build and workflows comply with regulatory requirements (CMS, HIPAA, payer rules).</li><li>
Support audits related to billing, claims, and remittance processing.</li><li>
Follow change management and documentation standards.</li></ul>
Qualifications
Required<div><ul><li>
Bachelor&rsquo;s degree in Information Systems, Business, Healthcare Administration, or a related field; or equivalent experience.</li><li>
1&ndash;3+ years of Epic experience preferred (Hospital Billing, Professional Billings, Claims, and Remittance).</li><li>
Hands-on experience supporting revenue cycle with focus on claims and electronic remittance.</li><li>
Understanding of healthcare billing workflows and payer interactions.</li><li>
Knowledge of EDI transactions (837, 835) and remittance processes.</li></ul></div><ul><li>
Strong analytical, problem‑solving, and troubleshooting skills.</li><li>
Excellent communication and customer service abilities.</li></ul>
Preferred<ul><li>
Epic certification in Billing or willingness to obtain within 90 days.</li></ul>
Competencies<ul><li>
Ability to translate billing workflows into technical Epic configuration.</li><li>
Strong attention to detail and commitment to documentation accuracy.</li><li>
Ability to work both independently and collaboratively with clinical teams.</li><li>
Strong organization, time management, and prioritization skills in a fast‑paced environment.</li><li>
Discretion and ability to manage PHI and sensitive patient information.</li><li>
Experience with Epic Hyperspace, Reporting Workbench, SmartTools, or clinical decision support is a plus.</li></ul>
Work Environment<ul><li>
Standard office environment with hybrid or in‑office options based on organizational policy.</li><li>
Occasional after‑hours or on‑call support during upgrades, go‑lives, and critical clinical workflows.</li></ul></div>

BILLING CLAIMS & ELECTRONIC REMITTANCE ANALYST

Western CBO

Universal Health Services (UHS) - Western Region Consolidated Business Office (WCBO)The Western Region Consolidated Business Office delivers comprehensive insurance revenue services to our affiliated UHS facilities, encompassing billing, collections, cash posting, pre-access management, variance analysis, and customer service. Our dedication to associate satisfaction and growth is recognized by industry leaders, exemplifying our commitment to fostering a positive and inclusive workplace culture. Our associates can count on competitive salaries, top-tier medical, dental, and retirement benefits, career training, and support for continued professional development.Job Description: Reimbursement Analyst The Reimbursement Specialist Analyst analyzes reimbursement trends and identifies underpayments, facilitates reconsiderations, and appeals with payers. This role coordinates and oversees the complete process of underpayment reconsiderations, including correction of insurance plan errors, payment transfers, and account adjustments.Experience:2 + years medical contracts and claims experience.Education: High School or equivalent.Requirements:<ul><li>Experience in medical payer contracts. Explanation of benefits experience preferred.</li><li>Articulate with medical insurance terminology.</li><li>Strong attention to detail, analytical and critical thinking.</li><li>Strong Microsoft Office (Excel and Word) and 10-key data entry skills.</li></ul>This opportunity offers the following:<ul><li>Challenging and rewarding work environment</li><li>Growth and Development Opportunities within UHS and its Subsidiaries</li><li>Competitive Compensation</li><li>Excellent Medical, Dental, Vision and Prescription Drug Plan</li><li>401k plan with company match</li></ul>About Universal Health ServicesOne of the nation&rsquo;s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World&rsquo;s Most Admired Companies by Fortune; and listed in Forbes ranking of America&rsquo;s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.EEO Statement:All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.We believe that diversity and inclusion among our teammates is critical to our success.Notice:At UHS and all our subsidiaries, our Human Resources departments and recruiter are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.This position will be deemed the sole property of UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means.Pay: $19.00 - $25.17 per hourExpected hours: No less than 40 per weekBenefits:<ul><li>401(k)</li><li>AD&amp;D insurance</li><li>Dental insurance</li><li>Employee assistance program</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Loan forgiveness</li><li>Paid time off</li><li>Prescription drug insurance</li><li>Vision insurance</li><li>Wellness program</li></ul>Work Location: In person

REIMBURSEMENT SPECIALIST/ANALYST

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Claims Analyst II

Senior Claims Analyst - Allied Health Professional Liability

Senior Claims Analyst - Allied Health Professional Liability

Senior Claims Analyst - Allied Health Professional Liability

Senior Claims Analyst - Allied Health Professional Liability

BILLING CLAIMS & ELECTRONIC REMITTANCE ANALYST

REIMBURSEMENT SPECIALIST/ANALYST