Payer Operations Analyst
1 week ago
The Claims Resolution Professional at Momentum Resource Solutions will be responsible for reviewing and resolving claims processed by external vendors, including provider appeals and disputes.
Main Responsibilities- Conduct root cause analysis to identify areas for provider education and system configuration.
- Develop and implement plans to resolve all pended claims, (re)pricing, returned or refund checks, and the development of provider and facility compensation grids.
- Communicate with internal and external sources on claim-related matters.
- Analyze patient and medical information to identify COB, Worker's Compensation, No-Fault, and Subrogation conditions.
Requirements
- Bachelor's degree in a related field.
- Minimum 2 years of experience in claims resolution or a related field.
- Excellent analytical and problem-solving skills.
- Strong communication and interpersonal skills.
Salary Range: $75,000 - $95,000 per year, depending on experience.
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