Healthcare Analyst

4 weeks ago


Little Rock, Arkansas, United States Arkansas Government Job Full time
Job Summary

The Healthcare Analyst is a key role within the Arkansas Department of Human Services, responsible for examining provider and recipient insurance claims and records. This position requires strong analytical skills, attention to detail, and the ability to interpret and apply state and federal laws and agency policy governing healthcare.

Key Responsibilities
  • Examines claim forms, computer files, and other records to ensure compliance with claim requirements and identify payment problems.
  • Reports irregularities of insurance claim payments to supervisor and prepares correspondence regarding findings.
  • Interviews involved parties to obtain additional or clarifying information and documents interview and paperwork or medical records.
  • Approves or denies claim based on information, initiates changes to computer files, maintains log of corrections, and notifies involved parties of corrections or status of claim.
  • Provides technical assistance to requesting parties by researching claim, disseminating eligibility and policy and procedure information, answering questions regarding claim status, and updating provider pricing schedules.
  • Conducts regular or special surveys and studies, compiles data, analyzes information, and prepares related reports.
Requirements
  • The formal education equivalent of a bachelor's degree in general business, business education, office management systems, management, or a related field; plus one year of experience in documents examination, claims examination, or a related field.
  • OR The formal education equivalent of an associate degree in office occupations, business education, business management, or a related field; plus three years of experience in documents or claims examination or a related field.
What We Offer

The State of Arkansas is committed to providing equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, pregnancy, age, disability, citizenship, national origin, genetic information, military or veteran status, or any other status or characteristic protected by law.


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