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Medical Claims Consultant

2 months ago


Detroit, Michigan, United States Strategic Staffing Solutions Full time

STRATEGIC STAFFING SOLUTIONS IS HIRING

Position: Systems Analyst (Claims)

Location: On-Site Engagement

Duration: Long-Term Contract Engagement

Role Overview:

The selected candidate will play a crucial role in managing benefit modifications for various clients. This position involves working within the claims benefits system to gather and document requirements for system modifications, conducting claims testing, validating system improvements, and overseeing the implementation of changes.

Key Required Skills/Experience:

  • In-depth knowledge of medical and facility claims, including familiarity with the billing process, ICD codes, procedure codes, and diagnosis codes.
  • Proficient understanding of medical claims benefits processing.
  • Comprehensive knowledge of medical, dental, vision, and hearing benefits.

Additional Required Skills/Experience:

  • Strong analytical and organizational abilities, capable of managing multiple projects simultaneously.
  • Ability to produce clear and concise documentation that is accessible to individuals without specialized knowledge.
  • Proficiency in Microsoft Office Suite (Word, Excel, Access).
  • Excellent interpersonal and collaboration skills, fostering a team-oriented environment.

Preferred Skills/Experience:

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

Education/Certifications:

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

Job ID: JOB-236972

Publish Date: 06 Aug 2024

Tagged as: Systems Analyst (Claims)