Remote Claims Analyst

Overview

The Claims Analyst will be responsible for adjudicating medical healthcare claims that require high-level review and investigation, ensuring compliance with plan requirements and maintaining production quality.

In Short

• Adjudicate claims that pend during the auto adjudication process.
• Meet daily production requirements for claim processing.
• Achieve a quality score greater than 95%.
• Complete weekly pre-adjudication audit reports.
• Participate in regular feedback sessions with management.
• Communicate system issues for further investigation.
• Maintain effective communication with team members.
• Perform other duties as assigned.

Requirements

• 1-3 years of claims processing experience.
• Knowledge of CPT and ICD coding.
• Ability to work independently and prioritize tasks.
• Understanding of medical terminology and coding requirements.
• Proficient in Microsoft Office products.
• Strong problem-solving skills.
• Understanding of claims processing compliance.
• Effective written and oral communication skills.

Benefits

• Fully remote work environment.
• Comprehensive Medical, Dental, and Vision plans.
• 401(k) plan with employer match.
• Life and Disability insurance options.
• Flexible Time Off policy.
• Paid parental leave.
• Resources for professional growth and development.