Analytical Claims Escalation Specialist

Lake Charles Memorial Hospital; Lake Charles (LA); On-site; USD 42,000 - 62,000; Full time

Job summary

Lake Charles Memorial Hospital is seeking a Claims Escalation Analyst to manage and investigate escalated claims, ensuring timely resolution. The ideal candidate will have strong analytical and problem-solving skills, plus excellent communication with payers and internal teams.

Responsibilities include analyzing policy language and contracts, posting transactions, and coordinating with other departments to resolve issues delaying claims processing.

Qualifications

• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Proficient in Microsoft Office suite.
• Experience in healthcare billing or insurance preferred.
• Ability to work well in a team and handle escalated claims.

Responsibilities

• Analyze and interpret policy language, contracts and statutes.
• Maintain accurate records of all claims and ensuring timely resolution.
• Preview accounts to determine proper payment and identify errors in payments.
• Post transactions accurately including payments, adjustments, deductibles & coinsurance.
• Evaluate accounts to ensure payments and adjustments are correct.
• Collaborate with other departments to resolve issues delaying claims processing.
• Communicate with the assigned payer and escalate claims with carriers and departments.
• Document information in the system following the Clear Concise Consistent method.
• Monitor assignments to ensure goals are met and tasks are timely.

Skills

Analytical skills

Problem-solving

Communication skills

Microsoft Office

Education

High school diploma or GED

Tools

Microsoft Office Suite

Job description

Lake Charles Memorial Hospital is seeking a Claims Escalation Analyst to manage and investigate escalated claims, ensuring timely resolution. The ideal candidate will have strong analytical and problem-solving skills, plus excellent communication with payers and internal teams.

Responsibilities include analyzing policy language and contracts, posting transactions, and coordinating with other departments to resolve issues delaying claims processing.