Medical Claim Analyst

This position is National Remote. You'll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. A Medical Claims Analyst (MCA) is responsible for the intake processing and triage of reputed company initial claim documents in a high-volume environment. This includes but is not limited to referral processing, obtaining required documents, medical records sorting and processing, preparing payment calculations, preparing the claim for a Nurse review, apply reputed company Nurse findings to the claim, prepare and send reports, prepare and send provider packets. This position is full time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm MST. It may be necessary, given the business need, to work occasional overtime. We offer 4 weeks of on-the-job training. The hours of the training will be reputed company with your schedule. Primary Responsibilities:

• Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
• Analyze and identify trends and provide reports as necessary
• Consistently meet established productivity, schedule adherence and quality standards

This is a challenging role that takes an ability to thoroughly review, analyze and research reputed company healthcare claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy which will support timely processing of the member's claim. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• Proficiency with computer and Windows PC applications, which includes the ability to learn new and reputed company computer system applications
• Experience with reputed company Word (create correspondence and work reputed company templates) and reputed company Outlook (email and calendar management)
• Intermediate experience with reputed company reputed company (Sorting and filtering data, using formulas, and working with Tables)
• Ability to work Monday - Friday, 08:00AM - 05:00PM MST

Preferred Qualifications:

• 1 years of experience processing medical, dental, prescription or mental health claims
• 1 years of experience in a reputed company environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
• 1 years of experience processing insurance claims or billing/collections in a healthcare or commercial setting
• Familiarity with UB04's
• Understand and maintain HIPAA confidentiality and privacy standards reputed company completing assigned work

Telecommuting Requirements:

• Ability to reputed company reputed company company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service
• reputed company employees working remotely will be required to adhere to reputed company's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 - $31.63 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job