Claims Production Analyst II

Cotiviti

87d • $19 - $25

About The Position

The Claims Production Analyst will manage a thorough review of health insurance claims and member eligibility to identify overpaid claims that are non-compliant or misapply contract terms and rates, payment policies, medical policies, billing guidelines, and applicable regulatory requirements.

Requirements

• High School Degree or GED required.
• 2-5 years’ experience working on claims processing systems.
• Experience in claims auditing a plus.
• Ideal candidate will have experience in medical claims for commercial, Medicare, and/or Medicaid.
• Thorough understanding of medical terminology.
• Proficient in Microsoft Office and especially Excel.
• Must be able to multi-task in a fast paced environment.
• Must possess excellent analytical skills.
• Knowledge of Internet applications and customer service tracking systems a plus.
• Detail oriented team player.
• Excellent verbal and written communication skills.

Responsibilities

• Research claims accuracy and executes changes.
• Performs data validation.
• Audits incoming and outgoing claim files.
• Assists in loading claims to the claims system.
• Assists in research for provider inquiries.
• Interacts with the IT Department to facilitate workflow.
• Other duties as assigned.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Disability insurance
• Life insurance
• 401(K) savings plans
• Paid family leave
• 9 paid holidays per year
• 17-27 days of Paid Time Off (PTO) per year
• Discretionary bonus consideration

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees