Remote Jobs
Claims Research/ Data Analyst Sr (EDI/Edifecs)
This job is now closed
Job Description
- Req#: 300000991551306
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Competitive salary up to $80,000
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits package including healthcare, dental, and vision coverage
- Chance to work on complex projects with some mentoring
- Supportive work environment that fosters collaboration and innovation
What to Expect (Job Responsibilities):
- Review and analyze issues reported within the claims intake and processing ecosystem
- Validate data received on claims to identify billing issues affecting claims processing
- Monitor new solutions implemented to identify defects during the warranty period
- Collaborate with internal and external stakeholders to gain solution knowledge
- Set up proof of concept tests to research and resolve issues
What is Required (Qualifications):
- Associate degree or equivalent combination of education and experience
- 3-4 years of experience in healthcare claims and claim processing
- Deep understanding of Molina claims life cycle and processes affecting claims payment
- Ability to use critical thinking to analyze claim processing issues
- Strong SQL knowledge and familiarity with Edifecs
How to Stand Out (Preferred Qualifications):
- Bachelor's degree or equivalent combination of education and experience
- 5-6 years of experience in healthcare claims and claim processing
- Knowledge of claim pricing and complex claim payment methodologies
- Understanding of configuration solutions and Healthcare EDI Claims transactions
#HealthcareServices #ClaimProcessing #CareerOpportunity #CompetitivePay #SQLKnowledge
We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
The best remote jobs for you
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.