Claims Analyst

• Support the processing team with analysis of claim issues and inquiries.
• Perform root cause analysis and course correct identified issues for full resolution.
  Research root cause of incorrectly processed claims.
• Provide solutions and coordinate with appropriate team members to repair the claim and provide re-education to the processor or submit ticket for system enhancement.
• Focus on applying technologies to continuously increase claims process improvements with the use of data, Bots and applications/tools.
• Share this knowledge and skill with other team members to instill across the team the opportunities that they can escalate to process improve. Schedule reoccurring meetings to keep momentum.
• Responsible for evaluating current business processes and developing, implementing, testing and maintaining Technology for more cost effective or quality improvement processing.
• Assist with pulling the data needed and assist with the documentation of processes and work procedures.
• Represent Department as SME in meetings, projects and company initiatives
• Advanced skills in Microsoft Office and with Microsoft platforms (e.g. Excel, Word, PowerPoint) is required
• Experience with technologies, desktop tools and or Operations processes and technology is helpful
  Perform other duties as assigned

• Experience: 3 years or more of experience in medical claims processing and adjusting or healthcare administration.
• Experience working with health systems in the billing revenue space working with health system provider data, and medical claims administration.
• Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
• Working experience with SQL and Access is required.
• Technical Skills: Knowledge of medical billing codes (ICD-10, CPT, HCPCS), claims processing software. Ability to summarize large amounts of data and pivot data in multiple ways
• Analytical Skills: Ability to assess claim data in detail and identify errors or inefficiencies. Possess excellent mathematical skills and can work independently and within tight timeframes.
• Communication Skills: Strong written and verbal communication skills for interacting with various stakeholders and resolving issues quickly
• Attention to Detail: High level of accuracy and thoroughness in reviewing claims for clients

• Tableau experience is preferred

• Named One of America’s Best Employers for New Grads by Forbes (2024
• Named One of the Best Companies to Work For by U.S. News & World Report (Private Companies List, 2024-2025)
• One of the Largest IT Staffing Firms in the US – Ranked #3 by Staffing Industry Analysts (SIA, 2024)
• One of the Largest Staffing Firms in the US – Ranked #13 by Staffing Industry Analysts (SIA, 2024; includes Innova Solutions, Volt, & HireGenics)
• Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023)
• One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC, 2024)
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