Operations Analyst

Job Summary

A company is looking for an Operations Analyst to assist with workflow distribution, claim research, documentation processing, and operational/service pilot projects in support of Clinical Review operations.

Key Responsibilities

• Review and analyze claim appeals, coordinating with coders and assisting customers and providers with inquiries
• Manage claim inventory for various billing types and process documentation for special projects
• Perform data entry, database maintenance, and system claim adjustments while ensuring compliance with HIPAA regulations

Required Qualifications

• Minimum high school diploma or GED with two years of experience in an operations/service role; Associate's degree accepted without prior experience
• Experience in healthcare and knowledge of medical coding preferred
• Required licensures, professional certifications, and/or Board certifications as applicable
• Ability to use software and hardware related to job responsibilities, including MS Office Suites
• Ability to work independently and handle confidential information in a standard office environment