Ahs Claims Analyst Government
Little Rock, AR, US, United States
Job Description
ESSENTIAL FUNCTIONS/RESPONSIBILITIES
Determine the status of medical claims through research. Reviewing charges and member eligibility, explaining denial codes and plan benefits using established guidelines and standards. Follow-up on provider calls on status, explanation of payment, billing errors, and refund requests. Assists providers with interpreting claims EOPs and answering claims-related questions. Providing timely filing and appeal guidelines based on Medicare guidance. Maintain accurate and current activity reports and records for reporting to executive management. Comply with all regulatory requirements.
QUALIFICATIONS AND EDUCATION REQUIREMENTS
5 or more years of experience working in a healthcare claims environment. EDI processing experience preferred. Strong Knowledge of Medicare, Medicaid, and private insurance claims processing. Knowledge of Medicare Advantage and Medicaid programs. Excellent conflict resolution skills. Strong written communication skills. Knowledge of health plan technology Proficiency in MS Office Suite.
ROLE AND RESPONSIBILITIES
The Claims Analyst - Government is responsible for entering claims and answering provider-related claims inquiries. The Claims Analyst must be familiar with each plan's plan benefit package as well as standard CMS guidelines.
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Job Detail
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Job IdJD4418456
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IndustryNot mentioned
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Total Positions1
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Job Type:Contract
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Salary:58503 74077 USD
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Employment StatusPermanent
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Job LocationLittle Rock, AR, US, United States
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EducationNot mentioned