Job is Expired
Location: Alabama, Arizona, Connecticut, Florida, Georgia, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wyoming
Compensation: To Be Discussed
Staff Reviewed: Wed, Jun 08, 2022
Job Summary
A healthcare company is searching for a person to fill their position for a Remote Medical Claims Configuration Analyst.
Core Responsibilities of this position include:
- Assisting in the on-going evaluation of configuration for new and existing claims business rules
- Analyzing explanation of coverage documents to assist with determining best approach
- Assisting in the setup of code sets and defining pre-authorization guidelines
Qualifications Include:
- High school diploma or GED from an accredited institution
- Previous managed care/health plan experience in an operations department
- Experience delivering claims configuration processes within an Operations or Product Management environment
- Experience gathering and communicating complex claims configuration requirements
- Experience gathering and converting data into written narratives
- Hands-on experience with rules based table driven claims and eligibility administration systems
