Claims Analyst

Job Summary

A company is looking for a Claims Analyst I (Remote-NC).

Key Responsibilities

• Finalize claims processed for payment and maintain workflow, reconciliation, and quality control measures
• Provide customer service by handling provider inquiries and assisting with problem claims and training issues
• Review compliance and quality assurance measures, including internal bulletins and fee schedules

Required Qualifications, Training, and Education

• High School graduate or equivalent
• Three (3) years of experience in claims reimbursement in a healthcare setting or equivalent combination of education and experience
• Working knowledge of Medicaid Waiver requirements, HCPCS, revenue codes, ICD-10, and claims adjudication software
• Strong organizational skills and ability to manage multiple priorities
• Ability to maintain confidentiality of sensitive data