Remote Cost Transparency Analyst – Medical Claims

Yuzu Health; New York (NY); On-site; USD 65,000 - 75,000; Full time

Benefits offered by this job

Equity opportunities

Competitive salary

Health benefits

401K with employer matching

Career growth and development

Remote capabilities

High-trust, transparent autonomy

Job summary

Yuzu Health seeks a Cost Transparency Specialist to ensure accurate, timely, and compliant processing of manual submission medical claims. The role requires strong analytical skills, meticulous attention to detail, and knowledge of medical benefit categories.

You will work with Plan Designers and external partners to meet reimbursement timelines and maintain high-quality client experiences. The ideal candidate has 2+ years in claims processing, familiarity with CPT/ICD-10/HCPCS, and experience

Qualifications

• 2+ years of experience in medical claims processing or reimbursement preferred.
• Working knowledge of CPT, ICD-10, and HCPCS coding.
• Experience with manual claims workflows and explanation of benefits (EOB) review.
• Familiarity with self-funded health plans and employer-sponsored benefits preferred.
• Proficiency with computer skills.

Responsibilities

• Process and review manual medical claims submissions with a high level of accuracy and attention to detail.
• Apply knowledge of medical coding (CPT, ICD-10, HCPCS) to ensure proper adjudication and reimbursement.
• Interpret plan documents and reimbursement methodologies to ensure claims are processed in accordance with benefit design.
• Manage and support cash-pay workflows, including reviewing documentation and ensuring accurate and compliant processing.
• Communicate professionally with external partners regarding claims status, submission requirements, and processing details.
• Educate Plan Designers on claims procedures, reimbursement timelines, and required documentation.
• Support care navigation processes by ensuring accurate documentation and coordination of services.
• Identify, investigate, and elevate claims discrepancies or unresolved issues to ensure timely resolution.
• Maintain confidentiality and adhere to HIPAA guidelines and compliance standards.
• Contribute to process improvement initiatives as we scale and strengthen our Claims Operations and Support team.

Skills

Attention to detail

Medical claims processing

Analytical thinking

Communication

Problem solving

Job description

Yuzu Health seeks a Cost Transparency Specialist to ensure accurate, timely, and compliant processing of manual submission medical claims. The role requires strong analytical skills, meticulous attention to detail, and knowledge of medical benefit categories.

You will work with Plan Designers and external partners to meet reimbursement timelines and maintain high-quality client experiences. The ideal candidate has 2+ years in claims processing, familiarity with CPT/ICD-10/HCPCS, and experience