Claims Resolution Analyst

A company is looking for a Claims Resolution Analyst responsible for coordinating the resolution of claims issues at the health plan.

Key Responsibilities

Investigates and facilitates the resolution of claims issues by analyzing systems and processes across multiple operational areas

Coordinates efforts among internal departments to resolve issues within strict timelines

Performs claims and trend analysis while ensuring documentation accuracy and obtaining necessary approvals

Required Qualifications

Requires a BA or BS degree

5-7 years of claims experience

Minimum 1 year of experience in complex claims research or issue resolution within the managed care healthcare industry

Any combination of education and experience that provides an equivalent background may be considered