Hybrid (In Tampa) Medical Claims Analyst

TEKsystems • Tampa, FL

3d • $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

• Medical claims processing and billing experience (Medicaid, Medicare, Commercial, Workers’ Compensation).
• Knowledge of claims research, resolution, and appeals processes.
• Strong provider relationship management skills.
• Proficiency in Excel (pivot tables, reporting) and data entry.

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, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• 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)

What This Job Offers

• Career Level: Entry Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees