Medical Claim Analyst - CCR Audit & Compliance Pro

MaziCTools; Los Angeles (CA); Hybride; USD 34 000 - 50 000; Plein temps

Avantages offerts par ce poste

Health benefits

401(k) plan

Stock Purchase Plan

Life insurance

PTO

Résumé du poste

Aetna Wellbeing is hiring a Medical Claim Analyst in Arkansas to audit supplier and claimant submissions and ensure CCR survey compliance. You will follow standard processes and coordinate with CCR clinicians and clinical chiefs to produce a complete review.

The role requires a high level of accuracy, multi-tasking ability, customer support experience, and knowledge of clinical terminology. Full-time hours, with a comprehensive benefits package and 401(k) available.

Qualifications

• Bachelor degree required.
• Experience in claim handling is preferred.
• Familiarity with clinical terminology.

Responsabilités

• Audit supplier and claimant claims for CCR compliance.
• Follow processes, templates, and regulations to provide a complete review for CCR clinicians.
• Prioritize work to meet administrative and CCR guarantee timelines.
• Determine inclusion, verify qualifications, identify errors and apply policies to ensure proper claims processing.

Connaissances

Multi-tasking

Customer support

Clinical terminology

Formation

Bachelor Degree

Description du poste

Aetna Wellbeing is hiring a Medical Claim Analyst in Arkansas to audit supplier and claimant submissions and ensure CCR survey compliance. You will follow standard processes and coordinate with CCR clinicians and clinical chiefs to produce a complete review.

The role requires a high level of accuracy, multi-tasking ability, customer support experience, and knowledge of clinical terminology. Full-time hours, with a comprehensive benefits package and 401(k) available.