Wisconsin Claims Analyst

Job Summary

A company is looking for a Claims Analyst (ASO).

Key Responsibilities

• Process claims accurately and efficiently while adhering to production and quality standards
• Investigate claims for potential issues such as fraud and medical necessity, collaborating with internal and external contacts
• Provide professional written communication to clients, ensuring timely resolution of claim issues

Required Qualifications

• High school diploma or equivalent; some secondary education preferred
• 1-3 years of claims adjudication experience required
• Knowledge of third-party administration concepts is essential
• Familiarity with current procedural terminology (CPT) and ICD-9/ICD-10
• Experience with QNXT Claims Workflow and coding preferred