Claims Services Analyst

Job Summary

A company is looking for a Claims Services Analyst to review managed care contracts and compare them against healthcare claims to identify underpayments for clients.

Responsibilities:

• Thoroughly review managed care contracts and compare them against healthcare claims to identify underpayments
• Contact patients/guardians to obtain missing information needed by insurance companies to process claims
• Prepare and submit correspondence, such as letters, emails, and appeals, to insurance companies to explain and resolve underpayments

Qualifications:

• Minimum 1 year of experience in an operational setting, preferably in managed care or hospital patient accounts
• High School diploma or equivalent
• Moderate computer proficiency, including working knowledge of MS Excel, Word, and Outlook
• Experience working with ICD-9, CPT-4, and/or HCPCS coding systems
• Knowledge of insurance submittal procedures and medical forms