Claims Analyst
3 weeks ago
POSITION SUMMARY/RESPONSIBILITIES
Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff on complex claim issue resolutions. Work cooperatively with configuration in testing of contracts used in business operations and reporting assuring auto adjudication. Perform in accordance with company standards and policies. Promote harmonious relationships within own department, with other departments and within CFHP. Operate under limited supervision.
EDUCATION/EXPERIENCE
A high school diploma or GED equivalent is required. Five years HMO/PPO claims experience are required. Amisys claims processing system experience is preferred. Knowledgeable of all benefit programs offered by the CFHP, Medicaid, HMO, PPO, ASO.
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Business Analyst with P&C Claims Expertise
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Claims Analyst
3 weeks ago
San Antonio, United States University Health Full timePOSITION SUMMARY/RESPONSIBILITIES Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff on complex claim issue resolutions. Work cooperatively with configuration...
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Claims Analyst
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San Diego, United States KellyMitchell Group Full time$21.00 - $30.00 (est. hourly)Job Summary:Our client is seeking a Claims Analyst to join their team! This position is located in San Diego, California.Duties:Investigate and analyze recovery/subrogation and liability/property damage claims filed by or against the companyAdjust and settle claims as appropriateGather evidence for hearings, trials, and other...
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Senior Claims Analyst
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Senior Business Analyst, Information Systems
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Claims Examiner
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Claims Examiner
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San Diego, California, United States KellyMitchell Group Full timeKellyMitchell Group is seeking a skilled Claims Analyst to join their team in San Diego, California. The ideal candidate will have a strong background in claims investigation, liability analysis, and case management. Key responsibilities include: * Investigating and analyzing recovery and liability claims * Adjusting and settling claims as necessary *...
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Senior Business Analyst, Information Systems
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San Antonio, United States University Health Full timePOSITION SUMMARY/RESPONSIBILITIES The Senior Information Systems (IS) Business Analyst will have enterprise-level experience supporting IS application development teams and mapping of claims and clinical data. The Senior IS Business Analyst will be seen as a change leader across Community First, lead, and provide guidance to Health Care Analysts. This...
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Senior Business Analyst, Information Systems
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HB Claims Analyst
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Claims analyst
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Claims analyst
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Claims analyst
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Claims Processor
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Cyber Operations Analyst
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Configuration Analyst
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Configuration Analyst
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Claims Quality Assurance Auditor
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Data Analyst
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