Job Summary
A global healthcare company needs applicants for an opening for a Remote Senior Medical Claims Recovery and Resolution Analyst.
Candidates will be responsible for the following:
- Working with a team on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules
- Investigating all types of claims for health plans and commercial customers
- Conducting contestable investigations to review medical history
Qualifications for this position include:
- High school diploma / GED (or higher)
- Active Coding Certification (any of the following: CPC, CPC-H, CPC-P, CCA, CCS, CCS-P, RHIT, or RHIA), or an RN/LPN with an active license
- 2+ years of professional provider based medical coding experience
- 2+ years of experience with claims auditing and researching claims information
- 1+ years of experience analyzing data and identify cost saving opportunities
- Experience working with medical claims platforms
