Claims Analyst

Job Summary

Ensuring timely processing of medical claims, the full-time Claims Analyst will verify and update claim information, determine reimbursement eligibility, and manage claims in a remote work environment.

Key responsibilities

• Process first-time claims and apply policy provisions to assess claim payability
• Research and determine the status of medical-related claims while maintaining accurate records and documentation
• Meet department production and quality standards and complete additional claims training programs as required

Required qualifications

• High school diploma or equivalent
• 1 year of experience in the health insurance industry or claims processing
• Proficiency in Microsoft Office applications
• Basic knowledge of ICD-9/10, CPT, HCPCs, and medical terminology preferred
• Experience with Medicaid or Medicare claims preferred