Medical Claims Resolution Analyst

This is a fully remote position, open to applicants in Montana.

📋 Description

• Examine, investigate, and resolve medical claims in line with established processing protocols and guidelines.

• Evaluate claims challenges and collaborate with internal teams to guarantee prompt and precise resolution.

• Create and manage claim-related documentation, including Return to Provider (RTP) forms when necessary information is absent or incorrect.

• Handle multiple priorities while upholding productivity, accuracy, and service-level expectations.

• Update leadership and business partners on claim status, workload progress, and any potential issues as appropriate.

⛳️ Requirements

• Background in healthcare insurance, medical claims processing, claims resolution, or a similar healthcare operations setting.

• Exceptional attention to detail, analytical capabilities, and problem-solving expertise.

• Capability to multitask, prioritize responsibilities, and adhere to deadlines in a dynamic environment.

• Proficiency in Microsoft Office applications and the ability to navigate various systems to research and process claims.

• Excellent written and verbal communication skills, along with the capacity to interpret policies, procedures, and operational guidelines.

🏝️ Benefits

• Health benefits

• 401(k) employer match

• Generous flexible vacation policy

• Educational assistance

• Leadership and technical development academies