Claims Analyst -senior Systems Analyst-gr-21821-37901-jr184149

Carelon Global Solutions

Bangalore, India
Facets and wgs claims platforms
Commercial and gbd lobs
Healthcare claim lifecycle
Elevance Health is a leading health company dedicated to improving lives and communities and making healthcare simpler

Job Summary

  • Elevance Health is a leading health company dedicated to improving lives and communities and making healthcare simpler.
  • The Senior Systems Analyst will be responsible for expert adjudication of all GBD and CSBD claim types, with end-to-end experience across the claim lifecycle.
  • Carelon Global Solutions offers a world of limitless opportunities, fostering growth, well-being, innovation, and a sense of belonging.

Matching Summary

Elevance Health is a leading health company dedicated to improving lives and communities and making healthcare simpler.

Skills & Requirements

Must-have

  • FACETS and WGS claims platforms
  • Commercial and GBD LOBs
  • Healthcare claim lifecycle
  • CMS guidelines and pricing rules
  • CPT/HCPCS, ICD codes, modifiers
  • Complex claim handling

Nice-to-have

  • Excel VBA scripting for automation
  • SQL query writing for analysis
  • Innovative and agile work environment
  • Focus on learning and development

Key Requirements

  • 4-8 years of experience in GBD (FACETS) and Commercial (WGS) claims processing
  • Bachelors' or Masters' in Computer Science/IT or equivalent
  • Strong analytical and claims analysis skills

Work Rights

Not specified

Tailored Resume

Cover Letter