Claims Analyst

Job Summary

A company is looking for a Claims Analyst (remote).

Key Responsibilities

• Review, analyze, and resolve insurance claims for accurate and timely reimbursement
• Identify trends in denials and research payer requirements while collaborating with billing, collections, and appeals teams
• Maintain detailed documentation and communicate with payers and internal stakeholders to recommend process improvements

Required Qualifications

• Experience with Microsoft Office Suite (Word, Excel, Teams, Outlook)
• In-depth knowledge of MCG, Interqual, and ASAM Criteria
• Familiarity with Behavioral Health, IOP/PHP, and CD
• Experience with systems such as Meditech, Medik, OnBase, and Cerner
• Knowledge of RCM and insurance reimbursement processes is helpful