AmeriHealth Caritas · 1 day ago
Research Analyst
United States
Full-time
Remote
Entry Level
2+ years expAmeriHealth Caritas is a mission-driven organization dedicated to helping people get care and build healthy communities. The Research Analyst is responsible for researching, analyzing, and resolving projects or correspondence submitted by plans, providers, and other stakeholders, while also providing technical expertise and support to operations based on business needs.
HealthcareInformation TechnologyHealth Care
Responsibilities
Functions as Subject Matter Expert (SME) for Claims department
Analyzes complex operational claim payment problems and provides technical solutions
Identifies and recommends process improvement changes to existing processes and procedures which result in more efficient practices
Provides support to operations based on business needs
Responds to written providers’ inquiries
Maintains a current working knowledge of processing rules, contractual guidelines, plan policies and operational procedures to effectively provide technical expertise
Provides feedback regarding Online Help discrepancies and reports them to the Team Lead Educator
Provides technical and peer training as requested
Maintains accurate personal production records
Escalates claim and/or system issues to Team Lead or Supervisor
Completes provider correspondence and service forms as required
Creates and supports a professional environment which fosters teamwork, cooperation, respect and diversity
Meet department quality and production requirements
This position is required to meet and maintain performance goals established for the position in the areas of quality and production
Process claims for multiple Line of Business as requested by management
Understands processing rules for multiple lines of business and supports other lines of business as needed to meet business needs
Qualification
Required
2 to 3 years claims processing experience
High School/GED required
In-depth knowledge of claims payment methodology
Excellent research and analytical skills
Demonstrated ability in using computer and Microsoft Office applications, which includes strong keyboard and navigation skills and leaning new computer programs
Ability to research and investigate information using multiple sources and documented guidelines
Ability to track and follow up on multiple projects
Preferred
Associate's Degree preferred
Benefits
Flexible work solutions including remote options
Hybrid work schedules
Competitive pay
Paid time off including holidays and volunteer events
Health insurance coverage for you and your dependents on Day 1
401(k)
Tuition reimbursement
Company
AmeriHealth Caritas
AmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill.
10001+ employees
H1B Sponsorship
AmeriHealth Caritas has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (18)
2024 (17)
2023 (12)
2022 (14)
2021 (4)
2020 (11)
Funding
Current Stage
Late StageLeadership Team
Kathleen Giblin
SVP Clinical Operations
Ash Hanson
Executive Vice President & Chief Human Resources Officer
Recent News
2025-11-06
The Philadelphia Inquirer
2025-10-02
Company data provided by crunchbase