Claims Analyst

Paycom - ATS; United States; Remote; USD 52,000 - 78,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Short-term disability

401K with company match

Pension plan

Paid time off

Job summary

Southwest Service Administrators is seeking a Claims Analyst to review and process medical and dental claims from submission to final payment. You will gain and apply knowledge of plan designs, ensuring accurate processing and quality standards.

Collaborating with the team and participating in meetings and training, you will handle multiple projects, maintain accuracy, and seek opportunities to learn and grow within a dynamic environment.

Qualifications

• High School Diploma or GED required.
• Minimum 3 years of recent medical claims processing.
• Strong knowledge of CPT/ICD9/ICD10 and medical claim forms.

Responsibilities

• Review and process medical and/or dental claims from first submission to final payment.
• Understand plan designs and apply knowledge to claims processing.
• Maintain complete and accurate processing and high quality standards.
• Collaborate with team members and participate in meetings and training.
• Take on additional responsibilities and projects as assigned.

Skills

Medical claims processing

Medical terminology CPT ICD9/10

Typing 40 WPM

3+ years experience

Attention to detail

Education

High School Diploma or GED

Tools

Excel

Word

Pivot Tables

Lookup functions

Job description

The Claims Analyst is responsible for reviewing, analyzing and processing medical and/or dental claims. This role is responsible for analyzing claims from first submission and processing them to the final payment while maintaining complete accuracy, production and quality standards.ResponsibilitiesAnalyzing/ProcessingGain and maintain the understanding of the plan designs and effectively apply that knowledge.Analyze claims as appropriate from first submission to finalizing.Maintain complete and accurate processing.TeamworkWork cooperatively with other team membersActively participate in team meetings and training activities.Perform additional responsibilities and projects as periodically assigned.Education/Certification:(Minimum) High School Diploma/GEDThree (3) years recent experience processing medical claimsSkills/Abilities:Ability to maintain production and quality standards.Extensive knowledge of medical terminology, CPT Codes, ICD 9/10 and medical claim forms.Ability to read, analyze and assess medical documentation and draw valid conclusions.Minimum 40 WPM and 3,000 KPH proficiencySolid knowledge of MS Excel & MS Word (i.e. pivot tables and lookup functions).Professional, client-focused approach to colleagues and assignments.Strong oral and written communication skills with exceptional attention to details.Ability to seek out experiences that may change perspective or provide an opportunity to learn new things.Strong dedication to follow-through on all tasks and assignments.Ability to organize, set priorities, work independently and complete multiple projects within established deadlines.Ability to sit for long periods of time operating a computer keyboard.Employee Benefits ProgramCOMPANY PROVIDES:MEDICAL, DENTAL, VISIONSHORT-TERM DISABILITYFull coverage benefits for a low weekly premium of $5 (Employee Only), $15 (for Child(ren) and $20 per week for full family or Employee/Spouse.COMPANY PAID supplemental dental coverage of $1,000 per year for Employee.COMPANY PAID LONG TERM Disability & Life/AD&D coverage.401K Plan including company match up to 5%.COMPANY PAID additional pension plan entirely funded by the company.EXCEPTIONAL TIME OFF package including Paid Personal Leave (PPL) and Vacation with annual BUY BACK options!!!!Annual, automatic pay increases.Southwest Service Administrators provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, pregnancy, military and veteran status, age, physical and mental disability, genetic characteristics, or any other considerations made unlawful by applicable state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence compensation and training. Southwest Service Administrators expressly prohibits any form of workplace harassment based on race, color, religion, sex, national origin, pregnancy, military and veteran status, age physical and mental disability, or genetic characteristics.