Claims Analyst
The Health Plan (THP) · Charleston, WV · 2 mo ago
SalesFull-time
Responsibilities
- Performs initial review of all claim edits as directed.
- Completes or routes all reviews in accordance with time parameters established by The Health Plan.
- Reviews each claim flag in sequence, totally completing one at a time in accordance with established criteria/payment guidelines.
- Reports patterns of incorrect billing and utilization to manager or claims coordinator.
- Advises management of items that are unclear or that are not addressed in the established criteria/payment guidelines.
- Maintain a quality rating of 98%.
- Processes 15-20 claims per hour.
- Consistently displays a positive attitude and acceptable attendance.
- Participate in external and/or internal trainings as requested.
Requirements
- High school diploma or equivalent.
- Ability to follow written directions and work independently.
- Familiarity with medical terminology, CPT and ICD-10 coding.
- Computer and typing experience.
- Desired: Previous claims processing, experience in billing or physician office experience.
Qualifications
None specified.
Skills
None specified.
Benefits
None specified.
Pay
Not specified.
Schedule
8:00am to 5:00pm, 40 hours per week.