Claims Analyst

Profile

Claims Analyst

The candidate will be responsible for accurately and efficiently reviewing contracts, researching healthcare provider claims, thoroughly documenting investigation results and identifying and implementing appropriate and effective resolution strategies. Prioritize voluminous claim review workload. Validate claim status, claim liability and availability of coverage. Understand concepts of coverage, contract interpretation and reimbursement methodologies needed to analyze claims. Research and analyze information gathered through investigation to identify reimbursement issues, develop solutions and initiate appropriate claim resolution strategies. Maintain quality and productivity standards as set by Management. Influence others using a positive approach. Work independently with minimal supervision. Perform special projects as requested. Ensure compliance with Health Insurance Portability and Accountability Act. Must have 3-5 years of position specific related work experience (managed care, data mining and/or legal). Should have strong analytical, problem solving and research skills. Experience with Microsoft Office products; experience with healthcare provider claims management software is preferred. Excellent verbal and written communication skills is needed.

Additional Information

Send cover letter including salary requirements and resume.

Company info

Helton Law Group
7711 Center Ave Suite 350
Huntington Beach
California
United States 92647
Website : http://www.heltonlawgroup.com