Job Summary
A staffing agency is searching for a person to fill their position for a Telecommute Senior Healthcare Claims Analyst in Long Beach.
Core Responsibilities of this position include:
- Analyzing and researching claim disputes
- Conducting claim research, identify and resolving issue
- Updating created case in the system to document the claim research findings and decisions
Applicants must meet the following qualifications:
- Experienced in QNXT System to research and review how claim was adjudicated and reimbursed
- Experience in FFS claim reimbursement from a managed care health plan (as the payer)
- Know CMS and CA Medi-Cal billing requirements
- Know how to gather evidence from these regulatory sources.
- 3 years of experience related to claims processing, billing, adjustment, research, and dispute
