Medical Claim Analyst

📋 Description

• Accountable for reviewing post-service claims to assess reimbursements for both providers and members.

• Initiate the CCR process upon claim submission and conduct a thorough review of the claim and its history.

• Organize and prioritize tasks to comply with regulatory requirements and CCR claim turnaround times.

• Collaborate with both internal and external departments to ensure accurate review of designated claims.

⛳️ Requirements

• Minimum of 2 years of experience managing multiple assignments effectively.

• Familiarity with utilization management rules and regulations.

• Experience in claims processing and customer service is preferred.

• Must possess a verifiable High School Diploma or GED.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.