Senior Claims Analyst

Anticipated End Date:

2026-04-20

Position Title:

Senior Claims Analyst

Job Description:

JR188434 Senior Claims Analyst
 

CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services.
 

CareBridge is seeking a Senior Claims Analyst professional to support reporting, analytics, and process improvements across the claim’s lifecycle. In this role, you’ll use your claims expertise and SQL/data skills to turn complex data into actionable insights, support claim corrections, and improve workflows.

You’ll build reporting solutions, enhance submission performance, and partner with Product, Engineering, Finance, and Operations to improve and scale end-to-end claims processes.

Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
 

How you will make an impact:
 

Claims & Encounter Reporting

• Build and maintain reporting to track the full claims lifecycle from submission to payer response.

• Create self-service tools for Operations, Finance, and Client Success.

• Reconcile data across systems to ensure accurate claim status tracking.

Claims Subject Matter Expertise

• Act as an SME on claims structure, clearinghouse workflows, and payer responses.

• Support complex claim issues and partner with Product and Engineering to resolve data/workflow gaps and validate fixes.

Payer Configuration & Onboarding

• Support new payer implementations, including workflow setup and validation.

• Develop standardized monitoring for go-lives and streamline payer-specific processes.

Process Improvement & Operations

• Identify and resolve recurring submission issues.

• Partner cross-functionally to improve workflows, tools, and documentation.

• Support audits and quality reviews.

Minimum Requirements:

• Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 6 years systems analyst or business analyst experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• 5+ years of experience in provider-side claims, revenue cycle, or data management.

• Strong understanding of professional claim formats (837P), remittance advice (835), and clearinghouse workflows.

• Advanced SQL skills with experience querying complex healthcare production or analytics databases.

• Hands-on experience within a claims platform, including claim correction, resubmission, and configuration validation.

• Experience developing reports and dashboards using BI tools (e.g., Tableau, Power BI, Metabase)

• Ability to translate complex data into clear, actionable insights for business stakeholders.

• Strong cross-functional communication skills with experience partnering across Product, Engineering, Finance, and Operations.

• Experience working in value-based care environments.

Job Level:

Non-Management Exempt

Workshift:

1st Shift (United States of America)

Job Family:

IFT > IT Bus Systems Solutions Planning

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.