Claims Analyst

Job Title: Claims Analyst (Third Party Administrator)

Job Location: Remote

Department: Operations

Reports To: Claims Manager

Position Overview

We are seeking a talented and detail-oriented Claims Analyst to join a rapidly growing Third Party Administrator (TPA) supporting proprietary employer benefits programs. This role is responsible for reviewing and analyzing insurance claims to ensure accurate processing in accordance with plan documents, internal policies, and industry regulations.

The Claims Analyst will evaluate claims submitted through the system and make informed decisions regarding approval, denial, or adjustment. The ideal candidate has a strong understanding of healthcare benefits, claims system operations, and regulatory requirements, and is comfortable exercising judgment in a structured claims environment.

Key Responsibilities

• Review and Assess Claims: Analyze insurance claims submitted by providers...