As a Claims Analyst, you will be responsible for accurately and efficiently reviewing contracts, researching healthcare provider claims, thoroughly documenting investigation results and identifying and implementing appropriate and effective resolution strategies.
Specific position responsibilities include:
- Prioritize voluminous claim review workload.
- Validate claim status, claim liability and availability of coverage.
- Understand concepts of coverage, contract interpretation and reimbursement methodologies needed to analyze claims.
- Research and analyze information gathered through investigation to identify reimbursement issues, develop solutions and initiate appropriate claim resolution strategies.
- Maintain quality and productivity standards as set by Management.
- Influence others using a positive approach.
- Work independently with minimal supervision.
- Perform special projects as requested.
- Ensure compliance with Health Insurance Portability and Accountability Act.
- Other duties as assigned.
Specific position qualifications include:
- Three to five years of position specific related work experience (managed care, data mining and/or legal).
- Strong analytical, problem solving and research skills.
- Experience with Microsoft Office products; experience with healthcare provider claims management software highly preferred.
- Excellent verbal and written communication skills.
- Ability to multitask and thrive in a fast-paced work environment.
- Strong organizational skills and highly detail oriented.
- An interest in healthcare and healthcare law and the desire and ability to solve problems.
Qualified and interested applicants should send their cover letter including salary requirements and resume to firstname.lastname@example.org.