Healthcare Claims Analyst I: Appeals & Reimbursement

ADP, Inc.; Washington (District of Columbia); On-site; USD 50,000 - 60,000; Full time

Job summary

ADP, Inc. is seeking a Claims Analyst to assist with appeals and documentation submitted to health insurers and governmental payers. This role requires attention to detail and strong communication with attorneys and paralegals while maintaining the workload.

You will navigate client accounting systems, research accounts, submit appeals, and draft clear claims correspondence to insurers. A BA/BS and healthcare interest are preferred, with proficiency in Microsoft Office.

Qualifications

• Bachelor's Degree (BA/BS) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience.
• BA/BS with a GPA of 3.0 or higher.
• Interest in healthcare and healthcare law.
• Able to navigate through various computer systems and applications to find information about insurance claims.
• Ability to prioritize and multi-task.
• Excellent written and verbal communication skills.
• Proficiency in Microsoft Office, including Word and Excel.
• Excellent organizational and time management skills.
• High attention to detail.
• Clear, concise, and logical writing style.

Responsibilities

• Works within the client’s Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue.
• Determines action required to resolve the underpayment and initiate that action, including submitting appeals and reconsideration requests.
• Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal’s/attorney’s pursuit for additional reimbursement
• Quickly and efficiently prepares, reviews, and submits well‑written claims correspondence and related documents to insurers
• Is skilled, aggressive, cordial, and professional on the telephone to follow up on submitted appeals.
• Performs other related duties as assigned by management.

Skills

Excellent written and verbal沟通 skills

Education

Bachelor's Degree (BA/BS) from four-year college or university

GPA 3.0 or higher

Tools

Microsoft Office (Word and Excel)

Job description

ADP, Inc. is seeking a Claims Analyst to assist with appeals and documentation submitted to health insurers and governmental payers. This role requires attention to detail and strong communication with attorneys and paralegals while maintaining the workload.

You will navigate client accounting systems, research accounts, submit appeals, and draft clear claims correspondence to insurers. A BA/BS and healthcare interest are preferred, with proficiency in Microsoft Office.