Medical Claims Review Analyst

Job Summary

A company is looking for a Medical Claims Review Analyst (remote).

Key Responsibilities

• Evaluate disputed claims for system configuration and contractual issues
• Maintain detailed information on claims dispute files and track issues to support resolution
• Identify claims problems and document root cause analysis for management presentation

Required Qualifications

• Bachelor's Degree
• 2 - 3 years' related work experience in claims or benefits/billing environment
• Strong knowledge of claim processing policies and procedures
• Knowledge of medical terminology, ICD/CPT coding, and reimbursement procedures
• Proficiency with MS Office applications