Claims Analyst I

Integrated Resources Inc.; City of Syracuse (NY); On-site; USD 40,000 - 60,000; Full time

Benefits offered by this job

Referral bonus for good fits

Job summary

A reputable staffing firm seeks a Claims Analyst I to manage claims processing and analysis. The ideal candidate will possess strong claims knowledge and communication skills, and be proficient in Word and Excel. This role offers an opportunity for growth within a supportive team-oriented environment, focused on meeting deadlines and improving processes.

Qualifications

• 0-2 years in claims processing with progression to auditing or analysis.
• Project management skills and good communication skills required.

Responsibilities

• Process approximately 60 claims per day.
• Conduct analysis of claims payment processes to ensure accuracy.
• Perform system testing and validate electronic file loads.

Skills

Claims knowledge

Efficiency

Teamwork

Communication

Education

High School diploma or GED

Associate's degree (AA) preferred

Tools

Word

Excel

Job description

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-state area's most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since 1996. Our mission centers on delivering top-quality talent, the first time and every time. We provide resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy, and Nursing.

Job Description

Title: Claims Analyst I

Responsibilities:

• Monday - Friday, 9 am to 5:30 pm, with possible overtime
• Processing approximately 60 claims per day
• Seeking candidates with at least one year of claims knowledge, specifically in medical claims
• Key qualities: claims knowledge, efficiency, and teamwork
• Fast-paced environment created to meet deadlines
• Interview process includes phone screening followed by face-to-face interviews

Summary

Conduct analysis of claims payment processes to ensure system accuracy and proper provider payments.

Investigate problematic claims to identify root causes and errors, addressing both individual claim resolutions and process improvements to prevent future issues. Perform claims process testing to ensure accurate payments.

Testing categories include benefits, contract, and fee schedule configurations, as well as system enhancements.

Validate electronic file loads through report validation.

Essential Functions

• Perform claims system testing and analysis to verify configuration and payments.
• Research and analyze claims issues to resolve payment and configuration problems.
• Develop and execute test plans and scripts, documenting results for configuration updates supporting new business, benefits, and contracts.
• Provide feedback on claims processing to suggest improvements or manual interventions when necessary.
• Complete assignments within performance standards and deadlines.

Knowledge, Skills, and Abilities

• Excellent verbal and written communication skills
• Adherence to company policies
• Regular attendance as per schedule
• Confidentiality and compliance with HIPAA
• Ability to build positive work relationships with colleagues, clients, and providers

Required Education

High School diploma or GED; AA preferred

Required Experience

0-2 years in claims processing, with progression to auditing, claims analysis, or research. Level of autonomy and decision-making required.

Some project management skills, good communication skills, and advanced Word and Excel skills.

If you're not interested in new opportunities, referrals are appreciated. We offer a referral bonus if your contacts are a good fit for our client.