CrawlJobs Logo

Claims Analyst

United States, Providence · Job Posted April 12, 2026
Apply Position
Job Link Share

Job Description

We are seeking a detail-oriented Claims Analyst for a long-term contract on site in Providence, RI. Strong experience in Coordination of Benefits (COB), orthodontic or medical claims processing, and suspended/pended claims resolution. This role requires a thorough understanding of industry guidelines, plan provisions, and claim adjudication processes to ensure accurate and timely claim outcomes.

Job Responsibility

  • Coordination of Benefits (COB) Processing: Review and adjudicate claims to determine primary and secondary coverage in accordance with COB rules
  • Verify subscriber and dependent eligibility across multiple insurance plans
  • Apply industry-standard guidelines to ensure accurate benefit determination
  • Calculate correct payment amounts following primary insurer adjudication
  • Adjust claims based on Explanations of Benefits (EOBs) received from other carriers
  • Orthodontic Claims Processing: Evaluate orthodontic treatment plans for coverage eligibility and plan compliance
  • Verify lifetime maximums, age limits, and plan-specific orthodontic provisions
  • Process initial banding/bonding claims and ongoing periodic payments
  • Calculate prorated payments over the course of treatment
  • Monitor continuation of treatment and confirm ongoing patient eligibility
  • Suspended / Pended Claims Handling: Analyze suspended or pended claims to identify errors, missing documentation, or review flags
  • Determine root causes such as eligibility discrepancies, coding issues, or COB conflicts
  • Prioritize suspended claims based on aging, urgency, and service-level agreements (SLAs)
  • Escalate complex or high-risk issues to senior analysts or supervisors as appropriate
  • Ensure timely and compliant resolution in accordance with turnaround time standards

Requirements

  • Prior experience in dental and/or healthcare claims processing preferred
  • Strong knowledge of COB rules, orthodontic benefits, and claim adjudication practices
  • Ability to interpret EOBs, plan documents, and coverage guidelines
  • Excellent analytical skills with strong attention to detail
  • Ability to manage multiple priorities and meet deadlines in a fast-paced environment

What we offer

  • medical, vision, dental, and life and disability insurance
  • eligible to enroll in company 401(k) plan

Looking for more opportunities?

Search for other job offers that match your skills and interests.

Similar Jobs for

Claims Analyst

8 matching positions

Claims Analyst

As a Claims Analyst, you will serve as a subject matter expert and critical prob...
Location
Location
United States , Phoenix
Salary
Salary:
Not provided
arrivelogistics.com Logo
Arrive Logistics
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor’s degree in Business Administration, Finance, Accounting, or related field, or 3 years of professional experience in customer service, administrative support, or the insurance industry
  • 5+ years of experience managing claims required
  • Exceptional organization skills and high attention to detail
  • Proficient in Google Suite
  • conduct basic risk analysis and general data reporting
  • Superior written and verbal communication skills
  • Ability to work both independently and collaboratively
  • Strong critical thinking, judgment, and decision-making skills
Job Responsibility
Job Responsibility
  • Independently manage a portfolio of complex cargo claims from initial filing to final resolution, ensuring efficient, accurate, and timely handling
  • Lead and manage all high-level external communications and relationships with minimal management assistance
  • Comprehensively manage and reconcile all financial aspects of a claims portfolio, ensuring accurate balancing of all receivables and payables
  • Master the management of complex and high-value claims, frequently exceeding $100,000
  • Leverage deep business acumen and a comprehensive understanding of the transportation industry to strategically oversee claim operations
What we offer
What we offer
  • Medical, dental, vision, life, disability, and supplemental coverage
  • Matching 401(k) program
  • Employee Resource Groups
  • Free counseling sessions through Employee Assistance Program
  • Company paid holidays, paid vacation time and wellness days
  • 100% paid parental leave
  • Referral Program
  • Fulltime
Read More
Arrow Right

Claims Analyst

As a Claims Analyst, you will serve as a subject matter expert and critical prob...
Location
Location
United States , Columbus
Salary
Salary:
Not provided
arrivelogistics.com Logo
Arrive Logistics
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor’s degree in Business Administration, Finance, Accounting, or related field, or 3 years of professional experience in customer service, administrative support, or the insurance industry
  • 5+ years of experience managing claims required
  • Exceptional organization skills and high attention to detail
  • Proficient in Google Suite
  • conduct basic risk analysis and general data reporting
  • Superior written and verbal communication skills
  • Ability to work both independently and collaboratively
  • Strong critical thinking, judgment, and decision-making skills
Job Responsibility
Job Responsibility
  • Advanced Claims Operations & Trend Analytics: Independently manage a portfolio of complex cargo claims from initial filing to final resolution, ensuring efficient, accurate, and timely handling
  • This includes skillfully negotiating settlements, precisely processing all related financial transactions, and analyzing claims trends to identify recurring issues and significant financial exposure, with actionable findings presented to leadership
  • High-Level External Relations & Advocacy: Lead and manage all high-level external communications and relationships with minimal management assistance
  • Independently lead scheduled meetings with external parties, addressing complex inquiries, driving resolutions, and identifying actionable items to bring back to management for strategic consideration
  • Financial Integrity & Legal Compliance: Comprehensively manage and reconcile all financial aspects of a claims portfolio, ensuring accurate balancing of all receivables and payables
  • Possess a deep understanding of the distinctions between various payment methods and the strategic reasons for issuing legal documents like releases and assignments of rights in advance of cash payments
  • Utilize financial insights from claim trends to inform proactive strategies and protect the company’s financial interests
  • Expert Claim Resolution & Mentorship: Master the management of complex and high-value claims, frequently exceeding $100,000
  • Leverage deep industry knowledge to navigate intricate investigations and apply a comprehensive understanding of regulations, terms, and conditions to all claim values
  • Provide mentorship and guidance to junior team members on processing claims across the full range of values
What we offer
What we offer
  • Take advantage of our comprehensive benefits package, and supplemental coverage
  • Invest in your future with our matching 401(k) program
  • Build relationships and find your home at Arrive through our Employee Resource Groups
  • Maximize your wellness with free counseling sessions through our Employee Assistance Program
  • Take time to manage your physical and mental health – we offer company paid holidays, paid vacation time and wellness days
  • Receive 100% paid parental leave when you become a new parent
  • Get paid to work with your friends through our Referral Program
  • Fulltime
Read More
Arrow Right

Claims Analyst

As a Claims Analyst, you will serve as a subject matter expert and critical prob...
Location
Location
United States , Tampa
Salary
Salary:
Not provided
arrivelogistics.com Logo
Arrive Logistics
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor’s degree in Business Administration, Finance, Accounting, or related field, or 3 years of professional experience in customer service, administrative support, or the insurance industry.
  • 5+ years of experience managing claims required. Experience in cargo claims in a 3PL environment preferred.
  • Exceptional organization skills and high attention to detail.
  • Proficient in Google Suite
  • conduct basic risk analysis and general data reporting.
  • Superior written and verbal communication skills. You understand that proactive communication is key.
  • Ability to work both independently and collaboratively.
  • Strong critical thinking, judgment, and decision-making skills.
Job Responsibility
Job Responsibility
  • Independently manage a portfolio of complex cargo claims from initial filing to final resolution, ensuring efficient, accurate, and timely handling.
  • Skillfully negotiate settlements, precisely process all related financial transactions, and analyze claims trends to identify recurring issues and significant financial exposure, with actionable findings presented to leadership.
  • Lead and manage all high-level external communications and relationships with minimal management assistance.
  • Comprehensively manage and reconcile all financial aspects of a claims portfolio, ensuring accurate balancing of all receivables and payables.
  • Possess a deep understanding of the distinctions between various payment methods and the strategic reasons for issuing legal documents.
  • Master the management of complex and high-value claims, frequently exceeding $100,000.
  • Provide mentorship and guidance to junior team members on processing claims across the full range of values.
  • Leverage deep business acumen and a comprehensive understanding of the transportation industry to strategically oversee claim operations.
  • Drive and foster highly effective, cooperative working relationships with all internal departments.
What we offer
What we offer
  • Medical, dental, vision, life, disability, and supplemental coverage
  • Matching 401(k) program
  • Employee Resource Groups
  • Free counseling sessions through Employee Assistance Program
  • Company paid holidays, paid vacation time and wellness days
  • 100% paid parental leave
  • Referral Program
  • Fulltime
Read More
Arrow Right

Claims Analyst

As a Claims Analyst, you will serve as a subject matter expert and critical prob...
Location
Location
United States , San Antonio
Salary
Salary:
Not provided
arrivelogistics.com Logo
Arrive Logistics
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's degree in Business Administration, Finance, Accounting, or related field, or 3 years of professional experience in customer service, administrative support, or the insurance industry
  • 5+ years of experience managing claims required
  • Experience in cargo claims in a 3PL environment preferred
  • Exceptional organization skills and high attention to detail
  • Proficient in Google Suite
  • conduct basic risk analysis and general data reporting
  • Superior written and verbal communication skills
  • Ability to work both independently and collaboratively
  • Strong critical thinking, judgment, and decision-making skills.
Job Responsibility
Job Responsibility
  • Independently manage a portfolio of complex cargo claims from initial filing to final resolution
  • Skillfully negotiate settlements and precisely process all related financial transactions
  • Analyze claims trends to identify recurring issues and significant financial exposure
  • Lead and manage all high-level external communications and relationships
  • Independently lead scheduled meetings with external parties
  • Comprehensively manage and reconcile all financial aspects of a claims portfolio
  • Possess a deep understanding of legal documents like releases and assignments of rights
  • Master the management of complex and high-value claims, frequently exceeding $100,000
  • Provide mentorship and guidance to junior team members
  • Leverage deep business acumen to strategically oversee claim operations
What we offer
What we offer
  • Medical, dental, vision, life, disability, and supplemental coverage
  • Matching 401(k) program
  • Employee Resource Groups
  • Free counseling sessions through Employee Assistance Program
  • Company paid holidays, paid vacation time and wellness days
  • 100% paid parental leave
  • Referral Program
  • Fulltime
Read More
Arrow Right

Claims Analyst

As a Claims Analyst, you will serve as a subject matter expert and critical prob...
Location
Location
United States , Chicago
Salary
Salary:
58000.00 - 72000.00 USD / Year
arrivelogistics.com Logo
Arrive Logistics
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor’s degree in Business Administration, Finance, Accounting, or related field, or 3 years of professional experience in customer service, administrative support, or the insurance industry
  • 5+ years of experience managing claims required
  • Experience in cargo claims in a 3PL environment preferred
  • Exceptional organization skills and high attention to detail
  • Proficient in Google Suite
  • conduct basic risk analysis and general data reporting
  • Superior written and verbal communication skills
  • Ability to work both independently and collaboratively
  • Strong critical thinking, judgment, and decision-making skills
Job Responsibility
Job Responsibility
  • Advanced Claims Operations & Trend Analytics
  • High-Level External Relations & Advocacy
  • Financial Integrity & Legal Compliance
  • Expert Claim Resolution & Mentorship
  • Operational Strategy & Cross-Functional Synergy
What we offer
What we offer
  • Medical coverage
  • Dental coverage
  • Vision coverage
  • Life insurance
  • Disability coverage
  • Matching 401(k) program
  • Employee Resource Groups
  • Office wide engagement activities
  • Team events
  • Happy hours
  • Fulltime
Read More
Arrow Right

Claims Analyst

As a Claims Analyst, you will serve as a subject matter expert and critical prob...
Location
Location
United States , Austin
Salary
Salary:
Not provided
arrivelogistics.com Logo
Arrive Logistics
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's degree in Business Administration, Finance, Accounting, or related field, or 3 years of professional experience in customer service, administrative support, or the insurance industry
  • 5+ years of experience managing claims required
  • Experience in cargo claims in a 3PL environment preferred
  • Exceptional organization skills and high attention to detail
  • Proficient in Google Suite
  • conduct basic risk analysis and general data reporting
  • Superior written and verbal communication skills. You understand that proactive communication is key
  • Ability to work both independently and collaboratively
  • Strong critical thinking, judgment, and decision-making skills.
Job Responsibility
Job Responsibility
  • Advanced Claims Operations & Trend Analytics: Independently manage a portfolio of complex cargo claims from initial filing to final resolution, ensuring efficient, accurate, and timely handling
  • High-Level External Relations & Advocacy: Lead and manage all high-level external communications and relationships with minimal management assistance
  • Financial Integrity & Legal Compliance: Comprehensively manage and reconcile all financial aspects of a claims portfolio
  • Expert Claim Resolution & Mentorship: Master the management of complex and high-value claims, frequently exceeding $100,000
  • Operational Strategy & Cross-Functional Synergy: Leverage deep business acumen and a comprehensive understanding of the transportation industry to strategically oversee claim operations
What we offer
What we offer
  • Medical, dental, vision, life, disability, and supplemental coverage
  • Matching 401(k) program
  • Employee Resource Groups
  • Office wide engagement activities, team events, happy hours and more
  • Casual dress code
  • Work in Austin, TX
  • Free on-site parking
  • Fully stocked coffee bar, Broker's Brew
  • Onsite gym
  • Free counseling sessions through our Employee Assistance Program
  • Fulltime
Read More
Arrow Right

Associate Actuary / Sr. Actuarial Analyst, Claims Analytics

We're disrupting the transportation space and growing rapidly in both the U.S. a...
Location
Location
United States , Seattle, Washington; San Francisco, California; Chicago, Illinois
Salary
Salary:
118000.00 - 145500.00 USD / Year
uber.com Logo
Uber
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • BA/BS Math, Statistics, Economics, Actuarial Science or similar
  • Candidate with 4+ CAS Exams and a minimum of 3 years of Property & Casualty (P&C) actuarial experience
  • Excel skills, proficient with SQL (or similar querying language)
Job Responsibility
Job Responsibility
  • Deploy traditional actuarial skills in innovative ways to provide timely, accurate, and actionable claims insights that optimize Uber's insurance program
  • Perform deep dive analysis on claims data to identify operational opportunities, claims trends, and estimate impacts
  • Design, build, and maintain claims analysis tools that visualize, highlight, and summarize claims insights
  • Work cross-functionally with claims, data science, insurtech, and actuarial peers on analytics deliverables and communication of findings
What we offer
What we offer
  • Eligible to participate in Uber's bonus program
  • May be offered an equity award & other types of comp
  • Eligible to participate in a 401(k) plan
  • Various benefits
  • Fulltime
Read More
Arrow Right

EDI Technical Analyst (Claims)

Develops technical documentation, designs, analyzes, tests, provides end user su...
Location
Location
United States , Phoenix
Salary
Salary:
Not provided
azblue.com Logo
Blue Cross Blue Shield of Arizona
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 1 year of college-level coursework in system requirements design and interpretation and/or support of production systems (Level 1)
  • 3 years of experience in computer technology and/or information systems (Level 2 – 4)
  • 2 years of experience in data analysis, data management and integration, extracting and analysis reporting. (Level 2-4)
  • 2 years of EDI experience (Level 1)
  • High-School Diploma or GED in general field of study (All Levels)
  • Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
  • Intermediate PC proficiency
  • Intermediate proficiency in spreadsheet, database, flow charting, and word processing software
  • Intermediate knowledge of data mapping techniques and data analysis software
  • Intermediate knowledge of computer operating systems
Job Responsibility
Job Responsibility
  • Track and resolve basic or routine processing problems, coordinating with all areas
  • Research, analyze, track and resolve basic production problems
  • Develop business objectives, processing requirements, and technical specifications
  • Analyze files and map data from one system to another
  • Responsible for production cycles, solving production incidents and notification of problems
  • Write SQL queries needed for production support
  • Ability to query Splunk and App insight for logging results
  • Develop basic test data
  • Process test files and analyze test results
  • Create test files
  • Fulltime
Read More
Arrow Right