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Insurance Claims Analyst
2 months ago
Job Summary:
The Claims Examiner I role at System Soft Technologies involves ensuring accurate coding and processing of claims, meeting production goals, and adhering to company policies. This position requires a detail-oriented individual with excellent analytical and communication skills.
Key Responsibilities:
- Reviewing claim data for accuracy and completeness, ensuring compliance with regulatory requirements.
- Adjudicating medical claims and coordinating benefits, collaborating with healthcare providers to gather necessary documentation.
- Monitoring coding accuracy and following guidelines for coverage and liability determination.
- Maintaining high quality standards and productivity levels, processing and releasing claims within specified timelines.
- Assisting with claims investigations and escalations, handling other assigned tasks as needed.
Requirements:
- Excellent communication and analytical skills, with the ability to work in a fast-paced environment.
- Dependable, detail-oriented, and punctual, with a strong focus on quality and productivity.
- Proficient in data entry and medical claims processing, with experience working with ICD-10, CPT, and HCPCS codes.
- Strong computer skills, with the ability to learn and adapt to new systems and technologies.
- Associate's degree and 3-5 years of industry experience, with a strong understanding of healthcare claims processing and regulations.
Benefits:
- Competitive salary and benefits package, including medical, dental, and vision coverage.
- 401k with company match, 10 paid holidays, and generous PTO and sick leave.
