Medical Claims Analyst - Remote
TEKsystems•Charlotte, NC
•$25 - $30•Hybrid
About The Position
Seeking a Medical Claims Analyst to join the IBNR team. This role focuses on supporting claim and billing processes, provider outreach, and refund resolution. The ideal candidate will have strong analytical skills, medical claims experience, and the ability to navigate complex systems while maintaining accuracy.
Requirements
- At least 2+ years worker's compensations claims processing experience
- Experience working with IBNR claims
Responsibilities
- Provider Outreach: Contact providers, hospitals, and physician offices to obtain claim payments
- Claims Verification: Review bill history in the system to confirm receipt and accuracy of claims.
- Refund Processing: Handle refund requests, including overpayment analysis and reimbursement facilitation.
- Claims Research & Resolution: Investigate discrepancies, and resolve appeals
- Excel Reporting: Create and maintain reports, pivot tables, and document research findings.
- Follow-Ups: Ensure timely receipt of bills (within 10 business days) and complete end-to-end follow-up processes.
- High-Volume Management: Manage approximately 600 open cases and respond to daily email inquiries.
Benefits
- Medical
- dental
- vision
- Critical Illness
- Accident
- Hospital
- 401(k) Retirement Plan
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
