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 maintain compliance with company protocols while working remotely from anywhere in the United States.

Key responsibilities

• Process first-time claims and apply policy and provider contract provisions to determine 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, claims processing, or related office services
• Proficiency in Microsoft Office applications, including Word and Excel
• Basic understanding of ICD-9/10, CPT, HCPCs, revenue codes, and medical terminology preferred
• Ability to complete basic claims training programs within 6 months of hire