Claims Analyst

Verida Inc; Villa Rica (GA); In loco; USD 42.000 - 60.000; Tempo pieno

Descrizione del lavoro

Southeastrans is seeking a Claims Analyst in Villa Rica, GA to analyze processed claims for accuracy and compliance with provider contracts and company policies.

The role involves auditing claims, gathering information, analyzing trends, and supporting the development of claims analysis reports while maintaining confidentiality and integrity in all tasks.

Competenze

• High School Graduate or equivalent.
• Some college preferred.
• 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.
• Strong written and verbal communication skills.
• Basic working knowledge of Excel and Microsoft Office.

Mansioni

• Conduct audits and reviews of claims. Document the findings and recommendations.
• Request all information from internal or outside sources to ascertain completeness and validity of claims.
• Analyze claim trends to determine any necessary refinement of business rules and workflows.
• Contribute to the development of claims analysis reports.
• Research claims as needed.

Conoscenze

Communication skills

Teamwork

Confidentiality

Claims processing

Organizational skills

Compliance awareness

Formazione

High School Diploma or equivalent

Some college coursework preferred

Strumenti

Microsoft Excel

Microsoft Office

Descrizione del lavoro

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Claims Analyst

Southeastrans General Full Time Admin Support Worker Villa Rica, GA, US

3 days ago Requisition ID: 2626

SUMMARY: The Claims Analyst is responsible for analyzing a percentage of processed claims for accuracyaccording to the provider contract and company policies and proceduresby performing the following and other duties that may be assigned.

ESSENTIAL FUNCTIONS

• Conduct audits and reviews of claims. Document the findings and recommendations.
• Request all information from internal or outside sources to ascertain completeness and validity of claims.
• Analyze claim trends to determine any necessary refinement of business rules and workflows in order to improve the overall claims process.
• Contribute to the development of claims analysis reports.
• Research claims as needed.

REQUIRED SKILLS AND ABILITIES

• Displays written and verbal communication skills with administration and external parties.
• Able to work collaboratively, diplomatically, maintain confidentiality, and with integrity in problem identification and problem solving activities.
• Displays knowledge of ethical principles and compliance issues in an accounting setting.
• Knowledge of claims processing.
• Possesses good organizational skill, ability to focus on assigned tasks.

QUALIFICATION

• High School Graduate or equivalent. Some college preferred.
• 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.
• Strong written and verbal communication skills.
• Basic working knowledge of excel and Microsoft office.