Call Center Seguros

Claims Analyst

Job Description:

HEYA is hiring a Claims Analyst to process and adjudicate medical, pharmacy, and vision claims accurately and efficiently. The role involves researching claims, resolving inquiries, and ensuring compliance with policies and benefit structures.

Job and Responsibilities:

- Process and review assigned claims in a timely and accurate manner.
- Analyze claims based on diagnosis, provider details, policies, and contracts.
- Identify adjudication inaccuracies related to system configuration and benefits.
- Perform rework, medical reviews, and special projects as needed.
- Resolve pending claims and prior authorization requests.
- Provide research, feedback, and resolution support to internal teams.
- Achieve performance, production, and quality targets.
- Participate in training, knowledge sharing, and team initiatives.

Requirements:

- High School Diploma or equivalent (Bachelor?s degree preferred).
- 2+ years of experience in medical claims processing.
- Strong knowledge of medical terminology and claims adjudication.
- Proficiency in computer navigation and data entry.
- Excellent communication skills for internal and external interactions.
- Detail-oriented with strong analytical and problem-solving abilities.
- Ability to work in a fast-paced, production-driven environment.
- Strong teamwork, adaptability, and decision-making skills.
- High level of confidentiality and professionalism.
- GREAT ENGLISH!

What We Offer

- Compensation: Competitive salary
- Benefits: Health and life insurance, plus discounts at select stores and restaurants.
- Work Environment: On-site in Panama City, Panama, Monday to Friday,
- Tools and Resources: Company-provided computer and mentorship for professional growth.

If you?re looking for a role with growth potential in a supportive environment, apply now and start your journey with Heya!