Electronic Claims Analyst

Job Summary and Qualifications

The Electronic Claims Analyst’s function is to process electronic claims, research electronic claims processes, and assist other departments with electronic claims related issues as well as assist in creating new processes to improve data integrity.

Duties Include But Not Limited To

• Upload and process electronic claims
• Perform e-claim analysis that may have financial impact to the business
• Research and correct electronic claims related issues within Data Management
• Work with the Claims and Network Services Departments to resolve discrepancies with provider billing issues, such as Tax ID numbers, incorrect usage of NPI numbers, and Vendor addresses
• Correspond with providers regarding billing procedures to facilitate proper processing of e-claims
• Interface with users and technical staff for data entry and electronic claims issues
• Keep Data Management Manager informed of system and operational issues
• Lead projects for process improvement, reporting, infrastructure changes, new report definitions, etc.
• Provide technical assistance, training, and direction to electronic claims staff
• Participate in testing new claims requirements and processes in conjunction with other departments
• Develop, document, and manage workflows for electronic claims
• Provider back-up and assistance for Excelicare data loads
• Perform other duties as assigned

Knowledge, Skills and Abilities

• Excellent written and verbal communications skills
• Demonstrated analytical skills with ability to review information to determine appropriate action and define and resolve problems
• Ability to work independently and to prioritize tasks

Education

A high school diploma is required.

Experience

• One year equivalent work experience required
• Claims experience and/or knowledge of claims processes
• Experience in a Health Insurance environment

Benefits

HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing

Note

Eligibility for benefits may vary by location. Physician Services Group is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare’s graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of human life. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Electronic Claims Analyst opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews.

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.