Senior Claims Analyst

The Jacobson Group; United States; Remote; USD 28.000 - 39.000; Vollzeit

Benefits dieser Stelle

Medical insurance

Dental insurance

Vision insurance

401(k) retirement savings plan

Zusammenfassung

The Jacobson Group is seeking a detail‑oriented Claims Processor to handle corrected claim processing in QNXT. You will compare corrected and original claims and perform precise adjustments following established policies.

You will document corrections in the call-tracking system and use QNXT modules, the 837 repository, ELA View, and Business Objects to support accurate processing.

Qualifikationen

• 2+ years of experience processing and adjusting claims in QNXT.
• Experience identifying and processing corrected claims.
• Strong attention to detail and accuracy when reviewing claim changes.
• Ability to document claim adjustments and related activities clearly.

Aufgaben

• Process corrected claims in QNXT according to established policies and procedures.
• Review corrected claims against the original claim to identify provider-requested changes.
• Complete the required claim adjustments accurately.
• Document corrections and all steps completed in the call-tracking system.
• Utilize QNXT Claims, call tracking, member and provider modules.
• Review electronically submitted claims through the Internal 837 Claims Repository.
• Review paper-submitted claims through ELA View.
• Utilize Business Objects for existing corporate reports.
• Work with First Health, Clear Health and Claritev Ace as needed.

Kenntnisse

Attention to detail

Documentation

Tools

QNXT

Internal 837 Claims Repository

ELA View

Business Objects

Jobbeschreibung

Job Description

The Claims Processor will be responsible for processing corrected claims in QNXT following established policies and procedures. This role requires reviewing both the corrected claim and original claim to identify changes and making the appropriate adjustments.

Responsibilities

• Process corrected claims in QNXT according to established policies and procedures.
• Review corrected claims against the original claim to identify provider-requested changes.
• Complete the required claim adjustments accurately.
• Document corrections and all steps completed in the call-tracking system.
• Utilize QNXT Claims, call tracking, member and provider modules.
• Review electronically submitted claims through the Internal 837 Claims Repository.
• Review paper-submitted claims through ELA View.
• Utilize Business Objects for existing corporate reports.
• Work with First Health, Clear Health and Claritev Ace as needed.

Requirements

• 2+ years of experience processing and adjusting claims in QNXT
• Experience identifying and processing corrected claims
• Strong attention to detail and accuracy when reviewing claim changes
• Ability to document claim adjustments and related activities clearly

Pay Range

The anticipated pay for this position is $24.00 per hour. We understand salary is an important factor in a job search, and we encourage you to apply even if you feel that your desired compensation may fall outside of the listed range. The final pay for this position is determined based on several factors including but not limited to, relevant experience, skills and certifications, education and training, geographic location, market conditions, and internal equity. We are committed to finding the right candidate for this role and are open to discussing how your unique qualifications align with our needs.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• 401(k) retirement savings plan

Contact

Karrie Ruch
[phone]
[e-mail]

Refer a Colleague

Do you know someone who would be interested in this project? Submit your referral directly by emailing the Jacobson contact listed above or submitting them through this form. If your referral is hired for a contract assignment and meets all other eligibility criteria, you will receive a referral bonus!

Equal Opportunity Employer

The Jacobson Group is committed to fostering an inclusive and equitable workplace that reflects the diverse communities we serve. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status or any other protected characteristic as defined by applicable law. We believe that diversity of thought, background and experience strengthens our team and drives innovation. All employment decisions are based on qualifications, merit and business needs. If you require a reasonable accommodation to complete the application process or participate in an interview, please contact us at [e-mail] or [phone] to make a request.