Clearinghouse Claims Analyst
1 week ago
PRIMARY FUNCTION:
The Clearinghouse Claims Analyst is responsible for managing the inventory within the clearinghouses by ensuring issues are resolved or reported to the vendors and claims are billed in a timely manner according to state, federal and other third-party payer billing and reimbursement guidelines. Completes necessary paperwork for EFT/ERA enrollment.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Reviews inventory in clearinghouses daily to ensure all claims have been exported except for those with a valid hold reason. Notifies Billing Managers when outliers are discovered.
Identifies new errors and reviews with the Billing Managers to determine if updates are needed in the host system or a ticket needs to be opened with the appropriate clearinghouse.
Researches and resolves reported claim errors in a timely manner including the management of tickets with the clearinghouses.
Responsible for mapping payers in the clearinghouses.
Performs daily reconciliation from host system to the clearinghouses.
Collaborates with Billing Managers and IT in a timely manner when needed.
Provides training on the clearinghouses for new users along with refresher training as necessary.
Acts as a system administrator for user issues.
Assigns user logins and resets passwords as needed.
Runs trend analysis reports, analyzes data and reviews results with the Billing Managers.
Performs system maintenance updates as needed.
EDUCATION AND EXPERIENCE REQUIREMENTS:
Bachelor’s degree from an accredited college in a relevant field of study preferred.
Equivalent and relevant combination of education and experience may be considered in lieu of bachelor’s degree.
KNOWLEDGE, SKILL, AND ABILITY REQUIREMENTS:
Experience with Change Healthcare and Experian preferred.
The ability to recognize claim error trends and communicate immediately to billing managers.
Knowledge of medical terminology including cash posting, EOBs and insurance terminology.
Ability to work independently as well as in a team environment.
Ability to prioritize work and make frequent adjustments to priorities.
Ability to manage multiple concurrent activities.
-
Clearinghouse Claims Analyst
7 days ago
Wilmington, United States ChristianaCare Full timePRIMARY FUNCTION:The Clearinghouse Claims Analyst is responsible for managing the inventory within the clearinghouses by ensuring issues are resolved or reported to the vendors and claims are billed in a timely manner according to state, federal and other third-party payer billing and reimbursement guidelines. Completes necessary paperwork for EFT/ERA...
-
Clearinghouse Claims Analyst
2 weeks ago
Wilmington, United States ChristianaCare Full timePRIMARY FUNCTION:The Clearinghouse Claims Analyst is responsible for managing the inventory within the clearinghouses by ensuring issues are resolved or reported to the vendors and claims are billed in a timely manner according to state, federal and other third-party payer billing and reimbursement guidelines. Completes necessary paperwork for EFT/ERA...
-
Clearinghouse Claims Specialist
1 week ago
Wilmington, Delaware, United States ChristianaCare Full timeClearinghouse Claims AnalystAt ChristianaCare, we are seeking a highly skilled Clearinghouse Claims Analyst to join our team. This role is responsible for managing the inventory within the clearinghouses, ensuring issues are resolved or reported to the vendors, and claims are billed in a timely manner according to state, federal, and other third-party payer...
-
Multinational Claims Billing Analyst
2 weeks ago
Wilmington, United States Chubb Full timeThe Chubb Global Services (CGS) group focuses on delivering superior clients services to Chubb’s multinational business across Chubb’s diverse product line. The CGS Finance group oversees global money movement, billing and collections of reinsurance and deductibles, reporting, and overall multinational guidance and strategy. Reporting Relationship: The...
-
Regional Claims Analyst
3 weeks ago
Atlanta, GA, United States Brinks Full timeThe Brink's name is a promise to respect the trust we've earned in over 150 years in business. Every employee honors that promise by offering the highest levels of service and support to our customers. We take pride in our work, and we share a passion about our future. Learn why so many people have made the choice to join our team - and stay here. Job...
-
Multinational Claims Billing Analyst
2 months ago
Wilmington, United States Chubb International Full timeThe Chubb Global Services (CGS) group focuses on delivering superior clients services to Chubb’s multinational business across Chubb’s diverse product line. The CGS Finance group oversees global money movement, billing and collections of reinsurance and deductibles, reporting, and overall multinational guidance and strategy. Reporting Relationship: The...
-
Medicaid Claims Analyst
4 weeks ago
Parsippany, NJ, United States Cognizant Full timeAbout Us: Cognizant (Nasdaq: CTSH) engineers’ modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com The role is encouraged to drive technology discussions and analyze the current...
-
Medicaid Claims Analyst
3 weeks ago
Parsippany, NJ, United States Cognizant Full timeAbout Us: Cognizant (Nasdaq: CTSH) engineers’ modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com The role is encouraged to drive technology discussions and analyze the current...
-
Claim and Denials Coding Analyst
3 weeks ago
Allentown, PA, United States St. Luke's University Health Network Full timeSt. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other...
-
Business Claims Analyst
3 weeks ago
Rochester, NY, United States VirtualVocations Full timeA company is looking for a Business Claims Analyst Key Responsibilities: Analyzing complex business problems and issues using data from internal and external sources to provide insights to decision-makers Identifying and interpreting trends and patterns in datasets to locate influences Constructing forecasts, recommendations, and strategic/tactical...
-
Multinational Claims Billing Specialist
1 week ago
Wilmington, Delaware, United States Chubb Full timeJob SummaryThe Chubb Global Services group is seeking a highly skilled Claims Billing Analyst to join our team. As a key member of our Finance group, you will be responsible for delivering superior client services to Chubb's multinational business across our diverse product line.Key ResponsibilitiesCalculate, bill, and notify insureds and reinsurers of...
-
Claims Analyst
2 weeks ago
Paramus, NJ, United States Gellert Global Group Full timeGellert Global Group consists of many of the leading North American food importing companies (Atalanta Corporation, Camerican International, Finica, Tipico Cheese Products) and has been importing food products for over 100 years. The combined revenues of GGG exceed $1.7 billion. GGG companies provide strength in sourcing, insurance, finance, logistics, food...
-
Claims Adjuster Trainee
4 weeks ago
Val-de-Reuil, Normandie, United States National General Insurance Full timeJob DescriptionThe Claims Inside Auto Trainee Analyst II is responsible for investigating and confirming the facts of loss for automobile accidents. This role determines coverage, liability, damages and otherwise adjusts and negotiates claims within authority.Key Responsibilities:Handles basic investigation regarding most aspects of auto claims (coverage,...
-
Multinational Claims Billing Specialist
2 weeks ago
Wilmington, Delaware, United States Chubb Full timeJob SummaryThe Chubb Global Services group is seeking a highly skilled Claims Billing Analyst to join our team. As a key member of our Finance group, you will be responsible for delivering superior client services to Chubb's multinational business across our diverse product line.Key ResponsibilitiesCalculate, bill, and notify insureds and reinsurers of...
-
Claims Analyst I
2 weeks ago
Rockford, IL, United States Allied National, Inc Full timeDescription:PURPOSE:To learn Allied's Claims Processing system, the benefit structures and basic policy provisions in the Certificates of Insurance, and Allied's procedures and philosophies to process pre-approved claims. To make appropriate decisions on the claims reviewed and convey this information through written or telephone communications with agents,...
-
Principal Construction Claims Specialist
5 days ago
, CT, United States Arcadis Full timePrincipal Construction Claims AnalystArcadis is seeking a highly skilled Principal Construction Claims Analyst to join our Contract Solutions team in Middletown, CT. This role can be performed remotely.Arcadis is the world's leading company delivering sustainable design, engineering, and consultancy solutions for natural and built assets.We are more than...
-
Claims Assistant
21 hours ago
Farmington, CT, United States TEKsystems Full timeNOW HIRING CLAIMS ASSISTANT FOR LOCAL INSURANCE COMPANYFARMINGTON, CT (Hyrbid after first 90 days!)MON - FRI 40 hoursDirect Placement!Job Summary: To perform various administrative and technical tasks that will assist the claims department in handling claims.Job DutiesNotice of Loss: Review email and attachments received in the Notice of Loss mailbox to...
-
Workers Compensation Claims Specialist
23 hours ago
, OH, United States Flynn Restaurant Group Full timeJob Title: Workers Compensation AnalystAt Flynn Restaurant Group, we are seeking a highly skilled Workers Compensation Analyst to join our team. As a key member of our risk management team, you will be responsible for ensuring the quality and cost-effectiveness of our workers' compensation claims management process.Key Responsibilities:Investigate and manage...
-
Aviation Liability Claims Analyst
1 month ago
Saint-Bauzille-de-Putois, Occitanie, United States IAT Insurance Group Full timeIAT Insurance Group is seeking an experienced Aviation Claims Specialist to join our dynamic team. This role is pivotal in managing moderately complex Aviation Hull claims across the United States. The specialist will be tasked with assessing the company's liability and overseeing first-party aviation hull and bodily injury claims from initiation to...
-
Supervisor of Claims Production
2 weeks ago
Shawnee Mission, KS, United States Allied National, Inc Full timeDescription:PURPOSE: The Supervisor of Claims Production is responsible for the management and operation of the Claims Analyst staff which includes production, quality review, personnel matters, workflow, claims procedures and training. The Supervisor of Claims Production will have a detailed understanding of the computer system and working knowledge of the...