Date: Jun 25, 2024
Location:
Remote, Remote, US
Requisition ID: 9937
Description:
A Claims Analyst in the Healthcare field processes medical claims by verifying and updating information about submitted claims and reviewing the work processes required to determine reimbursement. They would be responsible for providing billing analyses of claims and applying standards of federal regulations to ensure correct billing practices.
Shift Hours; 8am to 5 pm PST
Job Duties
Application of policy and provider contract provisions to determine if a claim is payable. If additional information is needed, or if a claim should be denied.
Determine the status of medical claims through research
Reviewing charges, and use of payment or denial codes within established guidelines and standards
Maintenance of records, files, and documentation
Meet the standards of department production and quality standards
Qualifications
High School diploma or GED
Health claims processing experience a plus
Knowledge in the following a plus:
medical terminology
ICD-9/ICS-10, CPT, and HCPCS coding
HIPAA regulations
PC applications and systems
Ability to read and interpret general business correspondence, procedure manuals, and specific plan documents
Basic mathematical skills
Intermediate typing skills
Multiple computer application usage experience
We are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law.