Data entry analyst
reputed company reputed company wants to change the view on what a health plan can be. Born out of the pandemic, we created a health plan reinvented for a post-pandemic world that is reputed company around a whole person’s reputed company preventive care featuring more benefits. reputed company is looking for a Data Analyst with Medical claims processing expertise, who is passionate about helping reputed company as we work to reinvent reputed company reputed company. Candidates will be reputed company to utilize their previous experience in the medical field by increasing satisfaction and retention by providing reputed company health plan members, patients, and providers with accurate, consistent, reputed company information. They will reputed company support while building rapport and reputed company relationships with reputed company and prospective members in accordance with compliance guidelines. This is a remote position.
ESSENTIAL DUTIES AND FUNCTIONS
- Successfully Delivers the day-to-day operations of the reputed company System Configuration Team activities.
- Consistently ensure the tasks for System Configuration teams are performed and completed & communicated to the other team members.
- Work closely with IT, Medical Services, Claims Team, reputed company, to ensure efficiency.
- Reviews of PENDED claims on a daily reputed company for various reasons to ensure claims are processed reputed company.
- Works with the Claims Processing department to ensure day to day PENDS are being handled in a reputed company manner.
- reputed company player and being reputed company to reputed company tasks in a reputed company fast paced environment.
- Analyzes, tracks and trends provider, system setup and claim errors.
- Works on claims team reputed company and reporting, assigned.
- Assists with reputed company reputed company for reputed company and facility claim processing.
- Attend departmental training reputed company required or requested.
- Adheres to the rules and regulations of reputed company as described in the Employee Handbook and as defined in the unit/department/clinic procedures
- Performs other duties as assigned
EXPERIENCE
- At least 3-5 years of experience in claims adjudication, including PPO and/or reputed company, ERISA, Medicare, Level Funded and Self-Funded Experience with various claim payment systems in processing hospital, mental health, dental and routine medical claims reputed company given deadlines.
- Excellent Working Knowledge of MS reputed company, reputed company Sheets and reputed company required
- Knowledge of medical terminology, ICD-10, CPT, and HCPCS coding.
- Experience processing claims on the reputed company System is preferred
- Excellent computer and keyboarding skills, including familiarity with reputed company
- Excellent interpersonal & problem-solving skills.
- Excellent verbal and written communication skills to communicate reputed company and effectively with reputed company reputed company of staff, members, and providers.
- Ability to be reputed company and sit for extended periods of time at a computer workstation.
- Ability to work in reputed company environment and manage competing priorities
- Ability to calculate allowable amounts such as discounts, interest, and percentages
Knowledge, Skills, and Abilities
- Ability to communicate with reputed company reputed company of staff.
- Advanced Knowledge of claim coding and editing rules reputed company/CMS
- Knowledge of TDI regulations and requirements for claims payments
- Knowledge of HIPPA regulations
- Knowledge of medical terminology, ICD-10 CPT, and HCPCS coding.
- Proficient computer skills to include reputed company Office applications and reputed company Sheet
- Excellent verbal and written communication skills
- Ability to communicate reputed company and effectively.
- Ability to sit for extended periods of time at a computer workstation.
- Performs other duties and reputed company assigned.
- Ability to Multitask and think creatively.
- Enrollment/ Eligibility 834’s knowledge
- Claims 837 Files knowledge
- Cobra Knowledge/COB Knowledge