Claims Analyst

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    "requisitionDescription": "<div><div><div><div><div><div><div><link href=\"https://cdn.jsdelivr.net/npm/[email protected]/css/froala_editor.pkgd.min.css\" rel=\"stylesheet\" type=\"text/css\">&nbsp;<link href=\"https://cdn.jsdelivr.net/npm/[email protected]/css/froala_style.min.css\" rel=\"stylesheet\" type=\"text/css\"><div class=\"fr-view\"><p><strong>SUMMARY:</strong> The Claims Analyst is responsible for analyzing a percentage of processed claims for accuracy&nbsp;according to the provider contract and company policies and procedures&nbsp;by performing the following and other duties that may be assigned.</p><p><strong>ESSENTIAL FUNCTIONS</strong></p><ul type=\"disc\"><li>Conduct audits and reviews of claims. Document the findings and recommendations.&nbsp;</li><li>Request all information from internal or outside sources to ascertain completeness and validity of claims.</li><li>Analyze claim trends to determine any necessary refinement of business rules and workflows in order to improve the overall claims process.</li><li>Contribute to the development of claims analysis reports.</li><li>Research claims as needed.&nbsp;</li></ul><p>&nbsp;</p><p><strong>REQUIRED SKILLS AND ABILITIES</strong></p><ul type=\"disc\"><li>Displays written and verbal communication skills with administration and external parties.</li><li>Able to work collaboratively, diplomatically, maintain confidentiality, and with integrity in problem identification and problem solving activities. &nbsp;</li><li>Displays knowledge of ethical principles and compliance issues in an accounting setting. &nbsp;</li><li>Knowledge of claims processing.&nbsp;</li><li>Possesses good organizational skill, ability to focus on assigned tasks.</li></ul><p>&nbsp;</p><p><strong>QUALIFICATION</strong></p><ul type=\"disc\"><li>High School Graduate or equivalent. Some college preferred.&nbsp;</li><li>Minimum 2 years of relevant claims processing experience, preferably in a health care environment or a minimum of six months of internal claims processing experience.&nbsp;</li><li>Strong written and verbal communication skills.&nbsp;</li><li>Basic working knowledge of excel and Microsoft office.</li></ul></div></div></div></div></div></div></div></div>\n",
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