Claims Analyst I
hace 2 semanas
Job Summary:
We are seeking a highly skilled Claims Analyst I to join our team at Mcs Healthcare Holdings, LLC. As a Claims Analyst I, you will be responsible for analyzing and processing simple or non-complex professional and institutional claims, ensuring accurate and timely adjudication of payments.
Key Responsibilities:
- Analyze and process claims, including data entry, adjudication, and declining payments
- Request additional information from claimants as needed
- Receives, posts, records, and archives claims assigned to their work unit
- Cancels claims that have been worked on in their work unit
- Performs data entry of claims, referrals, and CHRA
- Processes CMS-1500 and UB-04 claims according to established processing and time rules
- Refers analyzed claims that require support from other departments
- Maintains an applicable financial and processing accuracy as established in the current policy and procedure
Requirements:
- Four-year high school diploma or equivalent
- Minimum two (2) years of experience in data entry in a Provider Call Center in the health insurance industry or a medical billing course
- OR
- Two (2) years of university studies equivalent to 60 approved credits or an Associate's degree
- Minimum of one (1) year of experience in data entry in a Provider Call Center in the health insurance industry or medical billing course
Language Skills:
Intermediate level in Spanish and English (writing, conversational, and comprehension)
Equal Employment Opportunity:
Mcs Healthcare Holdings, LLC is an equal opportunity employer and takes affirmative action to recruit women, minorities, protected veterans, and individuals with disabilities.
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