Home › Companies › Fa Evzu Saasfaprod1 Fa Ocs Oraclecloud Com CX 1 › Claims Review Analyst
Claims Review Analyst
Fa Evzu Saasfaprod1 Fa Ocs Oraclecloud Com CX 1 · United States; 7399 Westbranch Hwy-Lewisburg-EMP, Lewisburg, PA, US; 601 Memory Ln-Admin Bld Memory Ln 601A-EMP, York, PA, US · Active · Oracle Recruiting Cloud / Fusion HCM
Job facts
| Field | Value |
|---|---|
| Company | Fa Evzu Saasfaprod1 Fa Ocs Oraclecloud Com CX 1 |
| Title | Claims Review Analyst |
| Normalized title | - |
| Department / team | Revenue Cycle |
| Location | United States |
| Work model | - |
| Employment type | Full Time |
| Salary | - |
| Status | active |
| ATS provider | Oracle Recruiting Cloud / Fusion HCM |
| Posted / first seen | 2026-04-29 / 2026-05-31 |
| Changed / last seen | 2026-06-06 / 2026-06-06 |
Related slices
| Page | What it contains | Open |
|---|---|---|
| Company jobs | Active postings from Fa Evzu Saasfaprod1 Fa Ocs Oraclecloud Com CX 1. | Open |
| Company breakdowns | Role, location, ATS, and work model facets for this company. | Open |
| ATS provider jobs | Active postings observed through Oracle Recruiting Cloud / Fusion HCM. | Open |
| Provider filtered search | The same provider as a filtered job collection. | Open |
| Department jobs | Active postings in Revenue Cycle. | Open |
| Lifecycle events | Open, update, close, and reopen events for this posting. | Open |
| Original posting | Canonical source or apply URL captured from the ATS. | Open |
Linked records
| Company | Fa Evzu Saasfaprod1 Fa Ocs Oraclecloud Com CX 1 |
| Source | 141e2fa9-69c2-4818-bbbf-c9689ea3d0fe |
| ATS provider | Oracle Recruiting Cloud / Fusion HCM |
Description
Description
General Summary
Supports the system in charge capture, coding accuracy, and claim denials management. Conducts reviews of claim denials and submits appeals. Performs a variety of functions including, but not limited to answering inquiries and researching third party payer policies and coding guidelines to optimize reimbursement for the system while ensuring compliance with applicable laws and regulations.
Responsibilities
Duties and Responsibilities
Essential Functions:
Consults with departments throughout the system on charge processes. Ensures appropriate use of CPT, HCPCS and ICD-10 codes as well as modifiers.
Conducts reviews comparing medical record documentation to validate charge capture, medical necessity, and coding accuracy.
Investigates and recommends action steps and works collaboratively with the department when coding and/or compliance issues are found.
Identifies denial trends, billing errors, and determines root cause to prevent future denials.
Investigates billing system errors, through help desk tickets and work queues, due to potentially inappropriate documentation, coding, medical necessity or charge entry. Communicates with departments, including Compliance to initiate steps for resolution.
Investigates payer denials and institutes appropriate courses of action.
Prepares detailed appeals and attends Medicare Administrative Law Judge (ALJ) hearings as necessary for Medicare
Interacts with providers, managers, and staff in departments to ensure correct coding of claims.
Maintains current knowledge of payer/insurance policies, rules and regulations, including state and federal guidelines.
Demonstrates initiative and resourcefulness by communicating results of claims review activity to PCS and PFS Leadership.
Serves as point person for department when assigned and consistently displays good judgment, decision making and independence in the role, with minimal guidance and supervision.
Attends insurance update meetings, provides synopsis of bulletins and notifies affected areas.
Requests coding edits in EPIC based on payer bulletins and/or policies.
Assists leadership in PCS and PFS in the completion of routine assignments and special projects as needed.
Approves and processes all PB fee schedule requests via Remedy Force.
Creates and presents yearly ICD-10 and CPT changes.
Presents education, training and feedback to providers, practice managers and staff.
Common Expectations:
Adheres to established policies and procedures, objectives and quality assessment and safety standards.
Enhances professional growth and development through participation in educational programs, current literature, in-services meetings and workshops.
Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
Qualifications
Qualifications
Minimum Education:
High School Diploma or GED Required
Associates Degree Preferred
Work Experience:
3 years Billing/Claims and Coding experience. Required
Licenses:
Certified Professional Coder Upon Hire Required or
Certified Coding Specialist - Physician Based Upon Hire Required or
Certified Medical Coder Upon Hire Required or
Registered Health Information Technician Upon Hire Required
Knowledge, Skills, and Abilities:
Excellent communication and interpersonal skills.
Excellent oral presentation skills.
Experience with public speaking and basic computer skills.
Works effectively in a team environment.
Benefits Offered:
Comprehensive health benefits
Retirement savings plan
Paid time off (PTO)
Education assistance
Financial education and support, including DailyPay
Expanded Paid Parental Leave
For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org)
Full job record
| Job ID | 59b3ce40f6d911df96e99bb4d7b4fb936709ed86 |
| Org ID | b484349d-18e7-4347-bf77-a24fb2cebde7 |
| Source ID | 141e2fa9-69c2-4818-bbbf-c9689ea3d0fe |
| Board ID | 141e2fa9-69c2-4818-bbbf-c9689ea3d0fe |
| Provider | oracle_hcm |
| Provider Job Key | 223928 |
| Title | Claims Review Analyst |
| Normalized Title | — |
| Status | active |
| Active | yes |
| Location Text | United States; 7399 Westbranch Hwy-Lewisburg-EMP, Lewisburg, PA, US; 601 Memory Ln-Admin Bld Memory Ln 601A-EMP, York, PA, US |
| Department | Revenue Cycle |
| Team | — |
| Employment Type | full_time |
| Workplace Type | — |
| Remote Policy | — |
| Country | United States |
| Region | — |
| City | — |
| Salary Raw | Description General Summary Supports the system in charge capture, coding accuracy, and claim denials management. Conducts reviews of claim denials and submits appeals. Performs a variety of functions including, but not limited to answering inquiries and researching third party payer policies and coding guidelines to optimize reimbursement for the system while ensuring compliance with applicable laws and regulations. Responsibilities Duties and Responsibilities Essential Functions: Consults with departments throughout the system on charge processes. Ensures appropriate use of CPT, HCPCS and ICD-10 codes as well as modifiers. Conducts reviews comparing medical record documentation to validate charge capture, medical necessity, and coding accuracy. Investigates and recommends action steps and works collaboratively with the department when coding and/or compliance issues are found. Identifies denial trends, billing errors, and determines root cause to prevent future denials. Investigates billing system errors, through help desk tickets and work queues, due to potentially inappropriate documentation, coding, medical necessity or charge entry. Communicates with departments, including Compliance to initiate steps for resolution. Investigates payer denials and institutes appropriate courses of action. Prepares detailed appeals and attends Medicare Administrative Law Judge (ALJ) hearings as necessary for Medicare Interacts with providers, managers, and staff in departments to ensure correct coding of claims. Maintains current knowledge of payer/insurance policies, rules and regulations, including state and federal guidelines. Demonstrates initiative and resourcefulness by communicating results of claims review activity to PCS and PFS Leadership. Serves as point person for department when assigned and consistently displays good judgment, decision making and independence in the role, with minimal guidance and supervision. Attends insurance update meetings, provides synopsis of bulletins and notifies affected areas. Requests coding edits in EPIC based on payer bulletins and/or policies. Assists leadership in PCS and PFS in the completion of routine assignments and special projects as needed. Approves and processes all PB fee schedule requests via Remedy Force. Creates and presents yearly ICD-10 and CPT changes. Presents education, training and feedback to providers, practice managers and staff. Common Expectations: Adheres to established policies and procedures, objectives and quality assessment and safety standards. Enhances professional growth and development through participation in educational programs, current literature, in-services meetings and workshops. Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation. Qualifications Qualifications Minimum Education: High School Diploma or GED Required Associates Degree Preferred Work Experience: 3 years Billing/Claims and Coding experience. Required Licenses: Certified Professional Coder Upon Hire Required or Certified Coding Specialist - Physician Based Upon Hire Required or Certified Medical Coder Upon Hire Required or Registered Health Information Technician Upon Hire Required Knowledge, Skills, and Abilities: Excellent communication and interpersonal skills. Excellent oral presentation skills. Experience with public speaking and basic computer skills. Works effectively in a team environment. Benefits Offered: Comprehensive health benefits Retirement savings plan Paid time off (PTO) Education assistance Financial education and support, including DailyPay Expanded Paid Parental Leave For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org) |
| Salary Min | — |
| Salary Max | — |
| Salary Currency | — |
| Salary Period | — |
| Source URL | https://fa-evzu-saasfaprod1.fa.ocs.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/223928 |
| Apply URL | https://fa-evzu-saasfaprod1.fa.ocs.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/223928 |
| First Seen At | 2026-05-31 17:57:11Z |
| Last Seen At | 2026-06-06 19:24:29Z |
| Last Checked At | 2026-06-06 19:24:29Z |
| Last Changed At | 2026-06-06 19:24:29Z |
| Inactive At | — |
| Source Posted At | 2026-04-29 16:43:13Z |
| Source Updated At | — |
| Raw Payload Uri | s3://job-postings-prod-raw-590183727216/raw/provider=oracle_hcm/board=fa-evzu-saasfaprod1.fa.ocs.oraclecloud.com|CX_1/date=2026-06-06/2026-06-06T19-23-34-216Z-2f20e85ccb3e29486896386b360c095d2e329e80823af4601dc3a5489ee71292.json |
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