Claims Analyst

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  • 17-00196
  • Direct Placement
  • Claims
  • Huntington Beach, CA
Job Description
JOB TITLE
Claims Analyst

CLIENT COMPANY OVERVIEW
Our Company is an innovative legal resource center created to support and strengthen hospital revenue cycle operations. Founded over 20 years ago, their mission is and always has been to make healthcare better for everyone – and they do that every day by helping their clients resolve reimbursement issues, contract in ways to avoid problems, and strengthen payor/provider relationships in the process.

JOB SUMMARY
As a Claims Analyst, you will be responsible for accurately and efficiently reviewing contracts, researching healthcare provider claims, thoroughly documenting your investigation results and identifying and implementing appropriate and effective resolution strategies.

JOB DUTIES:

Prioritize voluminous claim review workload.
Validate claim status, claim liability and availability of coverage.
Understand concepts of coverage, contract interpretation and reimbursement methodologies needed to analyze claims.
Research and analyze information gathered through investigation to identify reimbursement issues, develop solutions and initiate appropriate claim resolution strategies.
Maintain quality and productivity standards as set by Management.
Influence others using a positive approach.
Work independently with minimal supervision.
Perform special projects as requested.
Ensure compliance with Health Insurance Portability and Accountability Act.

QUALIFICATIONS:

Three to five years of position specific related work experience (managed care, data mining and/or legal).
Strong analytical, problem solving and research skills.
Experience with Microsoft Office products; experience with healthcare provider claims management software highly preferred.
Excellent verbal and written communication skills.
Ability to multitask and thrive in a fast-paced work environment.
Strong organizational skills and highly detail oriented.
An interest in healthcare and healthcare law and the desire and ability to solve problems

COMPENSATION | POSITION CLASSIFICATION
$40k – $60k D.O.E.
Monday – Friday (days)
Full Time


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