Revenue Cycle Claims Analyst

Job Summary

A company is looking for a Revenue Cycle Claims Analyst.

Key Responsibilities

• Research, resolve, and prepare claims that have not passed payer edits and initiate action to resolve rejected drug claims
• Serve as a subject matter expert for provider relationships, service issues, reimbursement, and claims
• Monitor rejections on electronic and paper claims to enhance system edits and prevent ongoing rejections

Required Qualifications

• Bachelor's degree in Business, Healthcare, or a closely related field, or equivalent work experience
• 1 to 3 years of experience in healthcare, coding, finance, revenue cycle, patient accounting, or physician billing
• Certified Pharmacy Technician and/or Coding Certification (CPC, RHIT) preferred
• Advanced knowledge of professional billing flows and revenue cycle tasks
• Strong understanding of claim edits, coding systems, and Medicare billing guidelines