Healthcare Claims Analyst

3 weeks ago


Phoenix, Arizona, United States Triwest Healthcare Full time
Job Summary

The Coding and Reimbursement Analyst plays a critical role in ensuring claims payment accuracy and waste reduction initiatives by collecting, aggregating, and analyzing claims data from multiple systems.

Key Responsibilities
  • Collect and analyze claims data to identify trends and patterns.
  • Develop and maintain reports to communicate findings to stakeholders.
  • Collaborate with leadership and subject matter experts to develop process and quality improvement strategies.
  • Evaluate the completeness and accuracy of claims data.
Requirements
  • Bachelor's degree in Business Administration, Finance, Healthcare, or Information Management.
  • 3 years' experience in healthcare analysis, data management, or equivalent.
  • 3 years' experience in a claims environment with a strong knowledge of CMS coding and reimbursement methodologies.
  • Proficient in Microsoft Office suite, with an emphasis on Excel and data analysis and reporting.
Preferred Qualifications
  • Quality or Process Improvement experience.
  • Experience with data visualization tools such as Tableau, Power BI, etc.
  • Working knowledge of structured query language (SQL), and SQL Reporting Services (SRS).
  • Government claims experience.
  • Certified Coding Specialist (CCS) or Certified Professional Coder (CPC).
Benefits

We offer a comprehensive and progressive compensation and benefits package, including medical, dental, and vision coverage, generous paid time off, 401(k) retirement savings plan, and more.

At TriWest Healthcare Alliance, we value teamwork and are committed to creating an inclusive work environment that cultivates and supports diversity at every organizational level.



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