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Medical Claims Analyst

1 month ago

Yukon, United States Robert Half Full time
Job DescriptionJob Description

We are looking for a diligent Medical Claims Technician to join our team. The role is based in OKC, Oklahoma, United States, and offers a contract to hire employment opportunity. As a Medical Claims Technician, you will be involved in various responsibilities related to insurance claim processing and management within our finance department. Please note this role is 100% onsite in OKC, Oklahoma.


Responsibilities:


• Research and evaluate denied insurance claims, and resubmit them as necessary to ensure maximum accurate payment and reduce accounts receivable days.

• Communicate with office or clinical staff regarding coverage issues and denials when necessary.

• Maintain a high level of integrity and commitment to accurate claims processing.

• Use various computer programs and CMS platforms such as Allscripts and Cerner Technologies for efficient claims administration.

• Take on auditing and appeals tasks to ensure correct billing functions and benefit administration.

• Maintain an aged accounts receivable of less than 120 days.

• Attend staff meetings, workshops, and seminars to stay updated with agency policies, rules, regulations, and procedures.

• Use your analytical and problem-solving skills to work independently and collaboratively within a team environment.

• Perform other duties as assigned.

• Must possess a minimum of 2 years of experience as a Medical Claims Technician or in a similar role

• Proficiency in Allscripts, Cerner Technologies, and CMS Platform is necessary

• Knowledge of CL Programming and various computer programs is required

• Should have experience in appeals and auditing processes

• Familiarity with benefit functions and billing functions is a must

• Proficiency in claim administration is needed

• Ability to interpret and understand medical procedures and terminology

• Excellent analytical and problem-solving skills

• Strong communication and interpersonal skills

• High attention to detail and a high degree of accuracy

• Able to work independently and part of a team

• Bachelor's degree in Health Administration, Business, or related field is preferred.