Claims Research Analyst

Job Summary

Working remotely in a full-time capacity, the Claims Research Analyst will efficiently conduct research on claims to prevent aging and erroneous disbursements, while also assisting with special projects as needed.

Key responsibilities

• Verify disbursement requests and research claims for validity, escalating issues as necessary
• Monitor inventory reports to ensure timely resolution of claims and provide documentation for audits
• Serve as a point of contact for providers, ensuring proper adjustments and billing for claims

Required qualifications

• High School Diploma or equivalent
• 3 years of experience processing claims in a healthcare environment
• 2 years of experience with claims systems
• In-depth knowledge of claims payment and refund policies
• Familiarity with medical terminology, CPT IV coding, and ICD 9 diagnosis codes