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Analyst, Claims Research
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Job Description
- Req#: 300001341511438
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Competitive benefits and compensation package
- Work in a collaborative environment focused on improving claims processing efficiency
- Engage in meaningful projects that contribute to compliance and operational excellence
- Be part of a team that values customer service and internal collaboration
What to Expect (Job Responsibilities):
- Conduct research and analysis for high-priority claims projects to identify processing errors
- Collaborate with various departments to address claims processing issues and implement remediation plans
- Evaluate claims according to standard principles and state-specific policies to ensure accuracy
- Tailor reports and data to meet the specific needs of claims projects
- Provide clear communication and presentations of claims research findings to leadership and operations teams
What is Required (Qualifications):
- Associate's degree or equivalent combination of education and experience
- 1-3 years of claims analysis experience
- 5+ years of medical claims processing experience across multiple states and claim types
- Familiarity with a variety of concepts, practices, and procedures related to claims analysis
- Proficient in Excel for data analysis and reporting
How to Stand Out (Preferred Qualifications):
- Bachelor's degree or equivalent combination of education and experience
- 1-3 years of claims analysis experience
- 6+ years of medical claims processing experience
- Project management experience
- Expertise in Excel and PowerPoint for effective data presentation
#HealthcareServices #ClaimsAnalysis #ProjectManagement #CareerGrowth #CompetitiveBenefits
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