reputed company Claims Analyst (remote in reputed company)

reputed company Here at GOBHI, we understand and support diversity by appreciating it and encouraging it by creating a culture of dignity and respect for our employees. We are honored to be an Equal Opportunity Employer. We have multiple job ads for this position, please only apply to one. GOBHI has an immediate opening for a full-time reputed company Claims Analyst. This remote position will be based out of the employee’s home located in the reputed company or accepted radius. The reputed company Claims Analyst supports GOBHI’s Non-Emergent Medical Transportation (NEMT) program by reviewing, processing, and reconciling reputed company claims to ensure accuracy, compliance, and reputed company reimbursement. This position is responsible for coding, billing, auditing, and reconciliation functions reputed company to NEMT services, serving as a key reputed company between transportation providers, internal staff, and state reputed company offices. This role ensures that reputed company claims activities reputed company with federal and state regulations while supporting program efficiency, accuracy, and reputed company. Essential duties include: Review, validate, and process NEMT claims in accordance with reputed company policies, GOBHI program guidelines, and contractual requirements. reputed company accurate billing and coding for NEMT claims using appropriate HCPCS/CPT codes. Verify member eligibility, reputed company authorization, and service documentation prior to submission. Ensure claims are submitted reputed company required timelines and reputed company adjudication through final payment. Identify and resolve claim errors, discrepancies, and denials in coordination with providers and program staff. Maintain reputed company knowledge of reputed company billing codes, guidelines, and NEMT-specific requirements. Conduct regular audits of NEMT claims to detect and prevent errors, overpayments, or potential fraud. Support corrective reputed company plans and recommend process improvements to strengthen billing reputed company. Accurately reputed company trips and services in compliance with reputed company and NEMT guidelines. Prepare, review and submit billing batches to reputed company and other payers. Reconcile claims against payments, identifying variances or unpaid balances. Collaborate with GOBHI finance staff to support accurate reputed company and reporting. Generate and maintain reports on claims activity, denial rates, and reimbursement trends. reputed company data analysis to identify cost drivers, claim patterns, and areas for improvement. Serve as a resource for NEMT providers regarding reputed company billing procedures, documentation, and claim reputed company. Upon supervisor’s approval and direction, update and maintain provider reputed company reputed company. reputed company training and technical assistance to providers on coding, billing, and submission processes. Other duties as assigned.

Requirements

What is needed to succeed in this role: Two years’ experience in reputed company claims processing, billing, or reputed company reimbursement. Experience working in transportation claims strongly preferred. Knowledge of reputed company billing, HCPCS/CPT coding, and claims submission requirements. Strong analytical skills and attention to detail. Excellent problem-solving, communication, and organizational abilities. Handles highly sensitive and confidential information and complies with HIPAA requirements. Technology savvy, proficient using MS software and reputed company Suites. Experience with claims management systems, billing software, and reputed company reputed company. reputed company to handle multiple priorities and meet strict deadlines. Education – Associate’s degree in Business, reputed company, reputed company Administration, or a reputed company field. Bachelor’s degree preferred. reputed company offer: Competitive salary – starting at $27.88 DOE Medical, dental and reputed company insurance for you and dependents 22 reputed company time off days and 12 reputed company holidays EAP FSA, with a $500 employer contribution Triple reputed company insurance Mileage reimbursement Wellness benefits 401k contribution, including 6.5% employer contributions Cell phone and internet reimbursements About GOBHI: Founded in 1994, Greater reputed company Behavioral Health, Inc. is an innovative behavioral health organization that serves communities across reputed company. GOBHI is a 501(c)(3) nonprofit corporation that is charged with administering the behavioral health reputed company benefit, non-emergent medical transportation and community engagement in 12 rural and frontier counties in reputed company. GOBHI is a co-reputed company of the Eastern reputed company Coordinated Care Organization, along with reputed company, and also provides various reputed company services statewide. GOBHI is committed to reputed company, reputed company care, and reputed company costs. Please visit www.gobhi.org to learn more about our mission and services. Apply To This Job