Medical Claims Analyst

Job Summary

A company is looking for a Medical Claims Analyst.

Key Responsibilities

• Analyze and validate inbound and outbound 837 and 835 claim files
• Collaborate with internal departments to resolve file-related errors and monitor daily operational reports
• Serve as the primary point of contact between Claim Operations and health plans, facilitating communication and issue resolution

Required Qualifications

• Bachelor's degree in a related discipline or equivalent work experience
• 3+ years of experience in healthcare claims processing and analysis, particularly with 837/835 files
• Strong understanding of HIPAA transaction standards and EDI formats
• Experience working with TPAs and major health plans is preferred
• Proficiency in Excel and data visualization tools is a plus