Blue Cross and Blue Shield of Vermont

Claims Analyst | Full Time

Category: Insurance


Blue Cross and Blue Shield of Vermont is looking for a Claims Analyst to join our team. Our company culture is built on an unwavering focus on our members and giving them the best service possible. We offer a balanced, flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision, 401k, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.

COVID-19: Blue Cross is requiring all employees and covered consultants to be fully vaccinated (including booster if eligible) against COVID-19 and provide proof of vaccination as of January 1, 2022. Those with a medical condition or sincerely held religious belief preventing them from being vaccinated can request an exemption without fear of retaliation or an impact on job candidacy

REMOTE WORK: Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin, VT office work two days per week in the office with flexibility to work remotely the rest of the week.

Claims Analyst Responsibilities:

  • Review all claims data submitted for accuracy and completeness.
  • Analyze claims to determine appropriate coding for processing.  Determine if procedure code is payable according to particular line of business.
  • Review provider pricing files to determine allowances for correct payment.
  • Review, investigate and resolve suspended claims relying on department procedures, using system files as necessary.
  • Determine the correct level of coding and/or reimbursement for claims relying on department procedures, using system files as necessary.

Claims Analyst Qualifications:

  • High school diploma or equivalent is required.
  • Strong data entry skills required.
  • Knowledge of medical terminology and medical coding strongly preferred.

Claims Analyst Benefits:

  • Health insurance (including vision)
  • Dental coverage (free to employees)
  • Wellness Program
  • 401(k) with employer match + automatic employer contribution
  • Life Insurance
  • Disability Insurance
  • Combined time off (CTO) – 20 days per year + 9 paid holidays
  • Tuition Reimbursement
  • Student Loan Repayment
  • Dependent Caregiver Benefits

*full job description attached to ADP posting


To Apply:

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