Claims Analyst 1

Austin, TX 78741

Posted: 05/03/2019 Category: Healthcare Job Number: 27684

Full time Medical Claims Coordinator openings in Austin, TX area with a major healthcare company! Starting ASAP! Apply now to Damian Sroka for consideration!

PAY RATE: $18 - $19 per hour (with possible increase in 90 days)

HOURS: Full-time 8am-5pm Monday through Friday

Position Responsibilities:
  • Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

Job Responsibilities:
  • The main purpose of a Claims analyst is to process pended medical claims, verifying and updating information on submitted claims and reviewing work processes to determine reimbursement eligibility.
  • Ensure payments and/or denials are made in accordance with company practices and procedures.
  • Organize and work with detailed office or warehouse records, using computer to enter, access, search and retrieve data.
  • Prepare and review insurance claim forms and related documents for completeness.
  • Provide customer service, such as giving limited instructions on how to proceed with claims or providing referrals to other facilities or contractors. Review claims to determine whether or not claimant is covered under a policy, review policy to determine coverage, and evaluate the extent of a settlement.
  • Authorize claim payments, set reserves on payments, ensure timely disbursement of funds, coordinate or conduct investigations on claims, identify claims with possible recovery from third parties, and consult with attorneys, doctors, and agents in regards to the disposition of complex claims.

Education/Experience High school diploma or GED required. Bachelor’ s degree in Business or related field preferred. 0-2 years experience required.

 

Education/Experience:

  • Managed care experience preferred, good interpersonal skills, reliability is mandatory, good attention to detail

  • High school diploma or equivalent.
  • Associate’ s degree preferred.
  • 0-2 years of experience

 

Apply now to Damian Sroka for consideration!

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