Claims Business Analyst for Medicare Advantage
3 weeks ago
At CommuniCare Corporate, we are seeking a skilled Claims Business Analyst to join our team. This fully remote position will involve reviewing and auditing medical claims, identifying inaccuracies in processing, and providing input on solutions.
Key Responsibilities:
- Effectively review and audit medical claims to ensure accuracy and compliance with Medicare regulations
- Monitor claims trends to identify configuration and payment errors
- Analyze report results to pinpoint trends and correlations in complicated data sets
- Research and interpret Medicare claim processing regulations and requirements
- Develop automated routines for extracting claims data
Requirements:
- Bachelor's degree in business, health care administration, or similar; or at least 2 years of experience working in health insurance field
- 2 years of experience with government health insurance (Medicare, Medicare Advantage, Medicaid) preferred
- Health insurance plan claim processing experience (adjudication, audit, review)
- Claim appeal experience preferred
- SQL familiarity and ability to run basic queries
What We Offer:
- Competitive wages and PTO plans
- Full-time employees enjoy a menu of benefit options, including life and disability plans, medical, dental, and vision coverage, and 401(k) with employer match
We are committed to providing a collaborative and dynamic work environment that fosters growth and development. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.
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