Senior Claims Analyst

Job Summary

A company is looking for a Claims Analyst-Senior.

Key Responsibilities

• Oversee and coordinate all aspects of claims processing and reprocessing for designated lines of business
• Communicate with providers and members to facilitate understanding and resolution of claims
• Monitor claims processing functional areas to ensure efficiency and compliance

Required Qualifications, Training, and Education

• High school diploma or equivalent required
• Five years of experience in claims processing/adjudication, provider billing, or health plans required
• Leadership experience can substitute for up to two years of experience
• Experience in medical terminology and ICD-10/CPT coding required
• Experience in computerized managed care systems preferred