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Claims Systems Specialist

2 months ago


Detroit, Michigan, United States Strategic Staffing Solutions Full time

STRATEGIC STAFFING SOLUTIONS IS HIRING

Position: Systems Analyst (Claims)

Location: Remote Work with On-Site Requirements

Engagement Duration: Long-Term Contract Engagement

Role Overview –

The selected candidate will play a crucial role in executing benefit modifications for various clients. This position involves working within the claims benefits framework to pinpoint and articulate requirements for system adjustments, conducting claims assessments, validating system improvements, and overseeing the execution of these modifications.

Essential Skills and Experience –

  • In-depth experience with medical and facility claims, including a solid grasp of the billing procedures, ICD codes, procedure codes, and diagnosis codes.
  • Comprehensive understanding of medical claims benefits processing.
  • Profound knowledge of medical, dental, vision, and hearing benefits.

Additional Required Skills –

  • Strong analytical and organizational capabilities, with the ability to juggle multiple tasks simultaneously.
  • Proficiency in creating clear and concise documentation that is accessible to individuals without specialized knowledge.
  • Familiarity with Microsoft Office Suite (Word, Excel, Access).
  • Excellent interpersonal and collaborative skills, fostering a team-oriented environment.

Preferred Qualifications –

  • Experience with NASCO 3270 Mainframe.
  • Background in membership and eligibility processes.
  • Familiarity with BFM/BFAST benefit configuration, including analysis, testing, documentation, and quality assurance.
  • Basic knowledge of SharePoint.

Educational Background –

  • Bachelor's Degree in a relevant field is preferred.
  • Certification in Medical Billing/Coding is advantageous.

Job ID: JOB-236972

Publish Date: 06 Aug 2024

Tagged as: Systems Analyst (Claims)