Healthcare Claims Analyst

Job Summary

A company is looking for a Client Services Analyst II who will focus on claim overpayment analysis.

Key Responsibilities

• Utilizes CMS, state, and client billing policies to identify claims overpayments with limited oversight
• Participates in reviewing paid health insurance claims to uncover overpayment trends
• Collaborates with data miners and stakeholders to identify overpaid claims and document findings

Required Qualifications

• 4-6 years of healthcare reimbursement experience, including claims analysis and auditing
• Demonstrated knowledge of healthcare claims processing, including various coding systems
• Experience in healthcare auditing and validating claims data accuracy preferred
• Familiarity with published healthcare guidelines and regulations
• Excellent analytical and time management skills