Medical Claims & Customer Service Analyst

Washington Regional Medical System; Fayetteville (AR); On-site; USD 42,000 - 54,000; Full time

Job summary

Washington Regional Medical System in Fayetteville, AR is seeking an Insurance Claims & Customer Service Analyst to review and process medical claims for accuracy, verify coverage, and resolve claim issues. You will support patients, providers, and internal teams with clear communication.

The role requires knowledge of ICD-10/CPT coding, strong analytical and problem-solving skills, and proficiency with claims processing software.

Qualifications

• High school diploma or GED required; associates degree preferred.
• Experience in a medical office setting and knowledge of healthcare insurance protocols.
• Proficiency with electronic claims processing systems and Microsoft Office.

Responsibilities

• Serve as a point of contact for customers, patients, and providers to answer questions and resolve issues.
• Review and audit medical claims for accuracy and completeness.
• Verify coverage and gather missing information from patients or policyholders.
• Explain claim decisions to stakeholders and communicate with internal teams.
• Ensure claims comply with policy terms, laws, and company procedures.
• Analyze claim data to identify trends or irregularities and support reporting.
• Utilize claims processing software to monitor and process claims.
• Submit and process insurance authorizations efficiently.
• Maintain accurate records of claims processing and outcomes.
• Adhere to HIPAA privacy rules and relevant regulations.

Skills

Healthcare insurance knowledge

Claims processing systems

Microsoft Office Suite

Education

High school diploma or GED

Associates degree in related field

Tools

Electronic claims processing systems

Microsoft Office Suite

Job description

Washington Regional Medical System in Fayetteville, AR is seeking an Insurance Claims & Customer Service Analyst to review and process medical claims for accuracy, verify coverage, and resolve claim issues. You will support patients, providers, and internal teams with clear communication.

The role requires knowledge of ICD-10/CPT coding, strong analytical and problem-solving skills, and proficiency with claims processing software.