Lead Claims Analyst

Job Summary

A company is looking for a Lead Claims Analyst to assist in coordinating claims unit operations and provide technical support.

Key Responsibilities

• Provide oversight to ensure Claims Analysts apply policies and determine claim payability
• Train and mentor claims analysts while assisting in the resolution of complex claims and inquiries
• Monitor claims quality reviews, document results, and assist in creating workflows for the department

Required Qualifications

• High school diploma or equivalent; associate degree or equivalent experience preferred
• 2+ years of claims processing experience, specifically with Medicaid, Marketplace, or Medicare claims
• Advanced skills in Microsoft Office (Word, Excel, etc.) and ability to perform math functions
• Knowledge of ICD-9/10, CPT, HCPCs, revenue codes, and medical terminology required
• Completion of claims basic training, COB advanced training, and ramp period is necessary