Claims Analyst

Claims Analyst - Remote/Hybrid POSITION

Medix Healthcare

San Francisco, CA 94108

Schedule:

• Monday-Friday 8am-5pm

$24.28 - 36.39 Hourly - FULL TIME

Job Details

Hourly

$24.28 - 36.39 Hourly - FULL TIME

Job Type

Full-Time

Qualifications

• Good English (verbal and writing) is required.
• College preferred.
• Insurance claims and Healthcare administration background strongly preferred.
• Strong computer skills required. Any programming / database skill is highly preferred.
• Advanced MS Excel skills including pivots, vlookup, conditional formatting
• MS Access skills are highly preferred
• Very strong data analytical skills
• Very strong claims data analysis
• Strong claims reimbursement knowledge
• Claims auditing experience
• Strong mathematics skills

Benefits

For your Health...

• Medical, Dental, and Vision Insurance
• Employer-Paid Basic Life Insurance/AD&D
• Voluntary Employee-Paid Life Insurance/AD&D
• Employer-Paid Short Term and Long Term Disability
• Employee Assistance Program
• Wellness Program

For your Wealth...

• HSA and FSA Options
• 401k Retirement Plan with Company Match

For your Wealth...

• Paid Time Off
• Travel Assistance Program

Full Job Description

Are you looking to advance your career in healthcare? We are currenting hiring for a mostly REMOTE Claims Analyst in the San Francisco area to support a growing healthcare organization. Apply to get your name in the mix and join our industry movement!

What we provide to you as a full-time teammate:

We offer a competitive benefits package that is on par with most of the leading healthcare organizations. Apply today if you are interested in getting your name in the mix!

Essential Duties and Responsibilities:

As a Claims Analyst you will…

• Accurately evaluates and adjudicates complex claims in a timely manner and according to set standards. Regular claims include but not limited to professional claims, Lab, DME, ambulance, as well as outpatient facility UB claims.
• Able to review and match authorization for the service.
• Assists in optimizing work flows, troubleshooting and problem solving to claims.
• Develop and maintains any/all necessary documentation for claims adjudication
• Identifies and resolves provider billing issues, including provider/vendor communication in writing.
• Ensures accurate interpretation of government laws, rules and any regulations, as well as internal organization guidelines.
• Research, accesses and utilizes on-line reference for claim issues and resolution.
• Assists with completion of claims audits conducted on TPA.
• Accepts and performs other duties as assigned, including frequent special projects.

Supervisory Responsibilities: This position has no supervisory responsibilities.

Expectations of Performance: The employee in this role shall be considered to be performing in an acceptable manner when carrying out the Core Values:

• Independent
• Detail Oriented
• Integrity
• Positive Attitude

Experience/Requirements

• Good English (verbal and writing) is required.
• College preferred.
• Insurance claims and Healthcare administration background strongly preferred.
• Strong computer skills required. Any programming / database skill is highly preferred.
• Advanced MS Excel skills including pivots, vlookup, conditional formatting
• MS Access skills are highly preferred
• Very strong data analytical skills
• Very strong claims data analysis
• Strong claims reimbursement knowledge
• Claims auditing experience
• Strong mathematics skills

Computer Skills: To perform this job successfully, an individual should have knowledge of basic office equipment such as: "EMR (electronic medical record system) MCG, Microsoft Excel computer, internet, email, copy and fax machines, and telephone.

Work Environment: This position is going to be Remote/Hybrid.

Job Type: Full-time

$24.28 - 36.39 Hourly - FULL TIME

Benefits:

• 401k
• Dental insurance
• Health insurance
• Life insurance
• Sick Time/Paid Time Off
• Vision insurance

Schedule:

• Monday-Friday 8am-5pm

#MedixMW