Medical Claims Analyst

Job Summary

Working remotely, the full-time Medical Claims Resolution Analyst will research, resolve, and process provider claims while ensuring compliance and delivering exceptional customer support.

Key responsibilities

• Review, research, and resolve medical claims according to established guidelines
• Analyze claims issues and coordinate with internal departments for timely resolution
• Prepare and process claim-related documentation, including Return to Provider forms when necessary

Required qualifications

• Experience in healthcare insurance, medical claims processing, or related healthcare operations
• Proficiency with Microsoft Office applications and ability to navigate multiple systems
• Strong analytical thinking and problem-solving skills
• Ability to multitask and prioritize work in a fast-paced environment
• Familiarity with policies, procedures, and operational guidelines related to claims