Wisconsin Licensed Claims Analyst

Job Summary

A company is looking for a Claims Analyst II to examine and process claims in accordance with established policies and procedures.

Key Responsibilities

• Adjudicate claims by following departmental policies and corporate guidelines
• Resolve claims and related issues in compliance with policy provisions
• Process payments for approved claims and ensure completeness and validity of claims applications and provider statements

Required Qualifications

• High school diploma or equivalent preferred
• 2-4 years of claims processing experience required
• Knowledge of current procedural terminology (CPT) and ICD-9/ICD-10
• Past experience using QNXT Claims Workflow is a plus
• Prior experience with ACA, Medicaid, or similar health plans preferred