Benefits Analyst – Customer Support
About The Position
At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don’t just process claims—we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work® , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. The Benefits Analyst serves as a front‑line Benefit Customer Service Representative while also being cross‑trained to support and back up Benefits Analyst functions. This role is ideal for someone who enjoys helping people, solving problems, and working in a fast‑paced, in‑office environment, while also having the aptitude and interest to grow into more technical benefits and claims analysis work. Primary responsibilities include responding to member and provider inquiries, reviewing and explaining benefits and claims, and supporting claims processing functions. Over time, this role will expand to include deeper claims review, auditing, billing analysis, and analyst‑level support. Accuracy, empathy, communication, and attention to detail are key to success in this position.
Requirements
- High school diploma or equivalent
- 1+ year of experience in health insurance claims processing or benefit customer service
- Working knowledge of claims workflows, billing practices, EOBs, and medical terminology
- Proficiency with Microsoft Office (Word, Excel, Outlook)
- Strong verbal and written communication skills
- Customer‑focused mindset with strong problem‑solving abilities
- High attention to detail and accuracy
- Ability to prioritize and manage workload in a fast‑paced, in‑office environment
- Reliable attendance and responsiveness to members, providers, and internal partners
Nice To Haves
- Medical coding experience
- Experience with self‑funded health plans or TPA environments
- Familiarity with CPT, ICD‑10, HCPCS, and industry billing standards
- Experience auditing claims or supporting billing corrections
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required
Responsibilities
- Serve as the first point of contact for members, providers, and carriers regarding benefit and claims inquiries
- Respond to inbound phone calls and written inquiries related to group health benefits and claims processing
- Review medical, dental, and prescription drug claims and explain EOBs and benefit determinations
- Interpret plan documents to answer coverage questions and resolve claim issues
- Research claim discrepancies and coordinate resolution with internal teams or providers
- Assist with appeals research and responses as defined by benefit plan documents
- Communicate clearly and professionally with members and healthcare providers
- Audit claims for accuracy and identify potential overpayments or errors
- Support Benefits Analysts by assisting with reporting, audits, and claim reviews
- Participate in cross‑training to provide coverage and backup for analyst functions
- Maintain accurate documentation while complying with client contracts and internal standards
Benefits
- 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
- Comprehensive benefits : Medical, Dental, Vision, Life, and Disability Insurance
- Retirement plans : 401(k) and Employee Stock Ownership Plan (ESOP)
- Career growth : Internal training and advancement opportunities
- Culture : A supportive, team-based work environment
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
1-10 employees
