Senior Claims Analyst II

University Health; San Antonio (TX); On-site; USD 55,000 - 75,000; Full time

Job summary

University Health is seeking a Claims coordinator to act as a resource in the department, coordinating, analyzing, and improving performance. You will document processes, research best practices, and assist owners in implementing changes while monitoring outcomes.

The role requires 5+ years of claims experience, with Medicaid/Medicare/Commercial exposure, and strong data collection and analysis skills to meet benchmarks.

Qualifications

• High school diploma required.
• 5+ years claims experience required.
• 1–2 years supervisory experience preferred.
• Medicaid, Medicare and Commercial claims experience required.
• 3+ or more years’ experience in project coordination in a managed care environment preferred.
• Proficiency in Word, Excel, and Powerpoint is required.
• Experience with the Cognizant QNXT core operating system is highly desirable.

Responsibilities

• Coordinate, analyze, and improve departmental performance.
• Document business processes and research best practices.
• Compile information and assist process owners to implement change and monitor performance.
• Provide project coordination through research, data collection and analysis.
• Interact with other Community First Health Plans departments.
• Help ensure systems, processes and reports enable the Claims department to meet internal and external benchmarks.

Skills

Process improvement

Data analysis

Project coordination

Documentation

Education

High school diploma

Tools

Cognizant QNXT

MS Word

MS Excel

PowerPoint

Job description

POSITION SUMMARY/RESPONSIBILITIES

Acts as Claims department resource to coordinate, analyze, and improve departmental performance. Identifies areas for improvement, documents business processes, researches best practices, compiles information and assists process owners to implement change and monitor performance. Responsible for providing project coordination through research, data collection and analysis to identify areas for increased operational efficiency, productivity and accuracy. Interacts with other Community First Health Plans, Inc. (Community First) departments. Helps ensure that systems, processes and reports enable the Claims department to meet internal and external benchmarks.

EDUCATION/EXPERIENCE

High school diploma required. Five (5) years claims experience is required. One to two (1-2) years supervisory experience preferred. Medicaid, Medicare and Commercial claims experience is required. Three (3) or more years’ experience in project coordination in a managed care environment is preferred. Proficiency in Word, Excel, and Powerpoint, is required. Experience with the Cognizant QNXT core operating system is highly desirable.