Conducts analysis around various claims payment processes to ensure accuracy of system configuration and provider payments. Investigates problem claims to determine root cause of problem and/or error to address both individual claim resolution and improvement to process to avoid issues from occurring in the future. Perform and execute various claims process testing requests to ensure desired results are met to support accurate claims payments. Testing categories include but are not limited to the following: Benefit, Contract, and Fee Schedule Configuration, System Enhancements, Report Validation, Validation of electronic file loads.
Required Education: High School graduate (or GED). Required Experience: 0-2 years of claims processing with advancement to auditing / claims analysis / claims research. Some project management skills. Good oral and written communication skills. Advanced Word and Excel skills.
All your information will be kept confidential according to EEO guidelines.
Claims Analyst • Syracuse, NY, United States
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