Medical Claims Analyst

Job Summary
We are seeking a highly skilled Medical Claims Analyst to join our team at Yale New Haven Health. This individual will be responsible for handling a high volume of third-party claims, ensuring accurate information is submitted to payers via the clearing house and/or payer intermediary in a timely manner.

About the Role
As a Medical Claims Analyst, you will initiate actions necessary to correct problems that prevent claims submission and/or contact individuals responsible for taking corrective action. You will also document all follow-up activities on accounts in a clear and concise manner. Additionally, you will identify and report trends of claim edits, denials, and rejections to the supervisor for further review.

Duties and Responsibilities

• Handle a high volume of third-party claims, ensuring accurate information is submitted to payers via the clearing house and/or payer intermediary.
• Initiate actions necessary to correct problems that prevent claims submission or contact individuals responsible for taking corrective action and document all actions appropriately.
• Complete daily claims submission within the timeframe designated by the supervisor.
• Resolve all clearing house rejections from third-party payers on a daily basis.
• Follow up on a high volume of paid and unpaid claims to expedite prompt and accurate payment based on established department workflows.
• Perform a variety of duties necessary to resolve individual credit balances based on departmental procedure.

Requirements
To be successful in this role, you will need a minimum of one to two years' experience in healthcare revenue cycle with third-party claims management and/or billing. A high school diploma or GED is required, and an Associate Degree in a business-related field is preferred. The ideal candidate will have excellent analytical and organizational skills, as well as the ability to communicate effectively both written and verbally. Microsoft Office skills are preferred.

Salary Information
The estimated salary range for this position is $60,000 - $80,000 per year, depending on qualifications and location. Please note that this figure is an estimate and may vary based on various factors.

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