Job Description

Are you early in your career and looking to deepen your expertise in U.S. health insurance claims? Join our team as a Senior Reporting Claims Analyst, where you’ll contribute to meaningful work, learn from experienced colleagues, and build strong analytical and problem‑solving skills.

In this role, you’ll help ensure accurate and timely resolution of insurance claims through careful review, investigation, and collaboration. This is an excellent opportunity for professionals with 1–3 plus years of experience who want to grow in claims analysis, health insurance operations, and data-driven decision-making.

Location: Hybrid Hartford, CT

Base Pay Range: $19.00 - $23.00 per hour plus bonus

Estimated Travel: Up to 10%

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

Claims Review & Analysis

• Review adjudicated claims for accuracy and compliance.
• Evaluate claims processing policies, guidelines, and provider contracts.
• Analyze historical overpayment trends and claims data to identify patterns or outliers.
• Assess insurance claims to determine coverage, liability, and eligibility.

Validation & Investigation

• Confirm key claim details such as claim ID, date of service, refund amounts, and overpayment reasons.
• Validate claim information in internal systems and match details against provided documentation.
• Conduct thorough investigations, gathering all relevant documentation needed for resolution.

Collaboration & Communication

• Work closely with internal teams and insurance adjusters to gather information and resolve issues.
• Support team members as needed to ensure smooth project execution.

Accuracy & Documentation

• Calculate correct claim payments.
• Maintain clear, organized records of claims, findings, and communications.
• Track overpayment projects and ensure high-quality, timely updates.
• Follow all client and company policies without exception.

Required Qualifications

• Good basic mathematics, reasoning, and interpretation skills
• Working knowledge of MS Excel for project delivery
• Expertise in U.S. Health Insurance Claims Processing
• Excellent communication skills for client interaction

Preferred Qualifications

• Bachelor’s degree or equivalent work experience
• 2–3 plus years experience in claims analysis or a related field
• U.S. healthcare experience
• Strong analytical and problem‑solving skills
• Experience in reporting and data analysis
• Proficiency with claims management software and tools
• Knowledge of insurance regulations and industry best practices
• Ability to work independently and collaboratively
• High attention to detail and accuracy
• Strong organizational and time management skills
• Commitment to confidentiality and ethical standards