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Claims Monitoring Analyst, Salem, OR

Organization: ATRIO Health Plans
Category: Professional
Location: Salem, OR
Date Job Posted: September 2, 2020
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At ATRIO, our mission is to improve health outcomes for our members and the communities we serve. We welcome dedicated, passionate, and innovative leaders who are ready to make a difference. We offer the opportunity to work in a rewarding, team-oriented environment, to earn a competitive salary and enjoy excellent benefits. We value talent, experience and a strong work ethic, but also place a premium on individuality, creative thinking and a strong sense of community.

We are currently seeking a Claims Monitoring Analyst. This is an hourly, non-exempt position in Salem, OR.

Position Summary: The Claims Monitoring Analyst is accountable for the implementation, oversight and maintenance of the claims monitoring program.

The Claims Monitoring Analyst will coordinate with the Claims Director to develop and facilitate daily, weekly, monthly, quarterly and annual monitoring of claims.

The Claims Monitoring Analyst conducts monitoring activities, including but not limited to:

  • Regular reporting of all claim types through recurring or ad-hoc reports, meetings, or other methods
  • Maintenance and monitoring of policies and work instructions related to monitoring activities
  • Developing business requirements to provide BI as part of creating new reporting and monitoring
  • Working with Claims Department staff to identify claims issues and report them on a regular basis.
  • Tracking progress of claims rates and metrics, as used by the Claims Department

Reporting Accountability: This position reports to the Claims Director

Primary Role and Responsibilities:

The Claims Monitoring Analyst will:

  • Monitor claims
  • Assist in creating reports on a monthly basis or more frequently as necessary, that are presented to the Claims Director
  • Other duties as assigned

Professional Competencies:

  • Knowledge of the health insurance and managed care industry
  • Knowledge of claims, claim types and coding
  • Communicate effectively verbally and in writing
  • Ability to effectively handle multiple priorities while meeting all deadlines
  • Establish and maintain effective working relationships with management, employees, and vendors,
  • Proficient skills in MS Office applications

Preferred Experience

Coding experience

Preferred Education and Training:

Bachelor’s degree in Health Care or related field;

Preferred Licensing or Certification:


Required Ongoing Professional Training:

Here are just a handful of the benefits our employees enjoy:

Company benefits

  • Health Insurance: We offer our employees the choice of a comprehensive PPO plan or HSA plan that covers the employee, their partners and families.
  • Dental Insurance: We have two dental coverages for our employees to choose from. Employee premiums are covered at no cost to the employee.
  • Vision Insurance: Our vision insurance premiums are covered at no cost to the employee for coverage of their family.
  • 401(k) plan: Our employees are eligible to contribute after 90 days of employment. Company match also applies.
  • Life and ADD Insurance: Premiums for base coverage for our employees are covered.

We also offer our employees benefits that help lead to a better work-life balance

  • Charity Matching Donation: We match donations made from our employees to charities of their choice and also provide up to two full days off paid for volunteer work.
  • Tuition Reimbursement: We offer our employees a tuition reimbursement program for them to further educate and improve themselves in their field.
  • Gym Membership Reimbursement: We provide a supplemental reimbursement for our employees who belong to a gym.
  • Paid Time Off: Our employees start accruing paid time off on their first day of hire. In addition, employees receive a personal day off, and seven paid holidays.

ATRIO is an equal opportunity, affirmative action Company committed to cultural diversity and compliance with the ADA. ATRIO encourages all qualified individuals to apply, and does not discriminate on the basis of any protected status, including veteran and disability status.

Please send resume and cover letter to attention Joel Kuhl.

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