Claims Research Analyst

Job Summary

A company is looking for a Claims Research Analyst to review and monitor adjudicated claims while providing support and training to provider agencies.

Key Responsibilities

• Process and analyze claims submissions, ensuring accuracy and compliance with policies
• Communicate with internal and external stakeholders to resolve claims issues and provide training
• Utilize data analytics to identify claims errors and support process improvement initiatives

Required Qualifications

• High School degree or equivalent with four years of related experience, or a Bachelor's degree with two years of experience
• Experience with Medicaid and IPRS preferred
• Knowledge of healthcare services, claims processing, and relevant regulations
• Proficiency in Microsoft Office, particularly Excel
• Ability to work independently and collaboratively across departments