Claims Analyst

Verida Inc • Villa Rica, GA

3d

About The Position

The Claims Analyst analyzes a percentage of processed claims for accuracy against provider contracts and company policies and procedures. The role includes conducting claim audits and reviews, documenting findings and recommendations, obtaining information needed to determine claim completeness and validity, analyzing claim trends to identify possible refinements to business rules and workflows, contributing to claims analysis reports, and researching claims as needed. The analyst may also perform other duties as assigned.

Requirements

• High school graduate or equivalent.
• At least 2 years of relevant claims processing experience, preferably in a health care environment, or at least 6 months of internal claims processing experience.
• Strong written and verbal communication skills, including communication with administration and external parties.
• Ability to work collaboratively and diplomatically, maintain confidentiality and integrity, and participate in problem identification and problem solving.
• Knowledge of ethical principles and compliance issues in an accounting setting.
• Knowledge of claims processing.
• Good organizational skills and ability to focus on assigned tasks.
• Basic working knowledge of Excel and Microsoft Office.

Nice To Haves

• Some college preferred.
• Relevant claims processing experience in a health care environment preferred.

Responsibilities

• Conduct audits and reviews of claims and document findings and recommendations.
• Request information from internal or outside sources to determine the completeness and validity of claims.
• Analyze claim trends and identify necessary refinements to business rules and workflows to improve the claims process.
• Contribute to the development of claims analysis reports.
• Research claims as needed.
• Perform other duties that may be assigned.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED