Senior Claims Analyst

1 month ago


New York, United States Tandym Group Full time

A special needs plan in midtown Manhattan is seeking a Senior Claims Analyst. This role will be responsible for overseeing complex claim processes and ensuring provider satisfaction.

Key Responsibilities:
- Manage end-to-end claims processing cycles
- Oversee quality control for third-party administrators
- Resolve issues related to claims handling and provider appeals/inquiries

Requirements:
- Extensive knowledge of NYS Medicaid system
- Ability to comprehend complex contract details
- Experience in claims investigation
- Familiarity with payment methodologies like DRG and ICD-10 coding systems

This role offers flexibility through a hybrid work model. Apply today


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