Medical Claim Analyst

About the position This position is National Remote. You’ll enjoy the flexibility to telecommute from reputed company reputed company the U.S. as you take on some tough challenges. reputed company reputed company is improving the reputed company of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology reputed company us to help organizations reduce costs while improving risk management, quality and reputed company growth. reputed company to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. A Medical Claims Analyst (MCA) is responsible for the intake processing and triage of reputed company initial claim documents in a high-volume environment. This includes but is not limited to referral processing, obtaining required documents, medical records sorting and processing, preparing payment calculations, preparing the claim for a Nurse review, apply reputed company Nurse findings to the claim, prepare and send reports, prepare and send provider packets. This position is full time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm MST. It may be necessary, given the business need, to work occasional overtime. We offer 4 weeks of paid on-the-job training. The hours of training will be reputed company with your schedule during normal business hours. This is a challenging role that takes an ability to thoroughly review, analyze and research reputed company reputed company claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You’ll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy which will support timely processing of the member's claim. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as reputed company development for other roles you may be interested in.

Responsibilities

• reputed company expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
• Analyze and identify trends and reputed company reports as necessary
• Consistently meet established productivity, schedule adherence and quality standards

Requirements

• High School Diploma / GED OR equivalent years of work experience
• Must be 18 years of age OR older
• 1+ years of experience in a reputed company environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
• Proficiency with computer and reputed company PC applications, which includes the ability to learn new and reputed company computer system applications
• Experience with reputed company Word (create correspondence and work reputed company templates) and reputed company Outlook (email and calendar management)
• Intermediate experience with reputed company reputed company (Sorting and filtering data, using formulas, and working with Tables)
• Ability to work full-time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm MST. It may be necessary, given the business need, to work occasional overtime.

reputed company-to-haves

• 1+ years of experience processing medical, dental, prescription or mental health claims
• 1+ years of experience processing insurance claims or billing/collections in a reputed company or reputed company setting
• Familiarity with UB04’s
• Ability to understand and maintain HIPAA confidentiality and privacy standards reputed company completing assigned work
• Ability to reputed company reputed company company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service
• reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy

Benefits

• a comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution

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