Claims Analyst

Verida IncVilla Rica, GA
11h

About The Position

The Claims Analyst is responsible for analyzing a percentage of processed claims for accuracy according to the provider contract and company policies and procedures by performing the following and other duties that may be assigned.

Requirements

  • Displays written and verbal communication skills with administration and external parties.
  • Able to work collaboratively, diplomatically, maintain confidentiality, and with integrity in problem identification and problem solving activities.
  • Displays knowledge of ethical principles and compliance issues in an accounting setting.
  • Knowledge of claims processing.
  • Possesses good organizational skill, ability to focus on assigned tasks.
  • High School Graduate or equivalent. Some college preferred.
  • Minimum 2 years of relevant claims processing experience, preferably in a health care environment or a minimum of six months of internal claims processing experience.
  • Strong written and verbal communication skills.
  • Basic working knowledge of excel and Microsoft office.

Responsibilities

  • Conduct audits and reviews of claims.
  • Document the findings and recommendations.
  • Request all information from internal or outside sources to ascertain completeness and validity of claims.
  • Analyze claim trends to determine any necessary refinement of business rules and workflows in order to improve the overall claims process.
  • Contribute to the development of claims analysis reports.
  • Research claims as needed.
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