Senior Claims Response Analyst

Job Summary

A company is looking for a Senior Claims Response Analyst, remote.

Key Responsibilities

• Review and finalize claims reports requiring approval and respond to inquiries from Home Plans
• Investigate claim appeals and disputes, preparing comprehensive responses and identifying root causes of denials
• Communicate resolutions to stakeholders and address inquiries regarding claim status and coverage

Required Qualifications

• Minimum 2-5 years of claims processing experience
• Knowledge of CPT and ICD coding
• Ability to read and understand benefit plan descriptions
• Intermediate to advanced understanding of Microsoft Office products
• Thorough understanding of claims processing compliance requirements