Medical Claim Analyst
Core
Inspects and provides accurate claim information to support savings optimization for claims, responds to customer benefit inquiries, and administers policies for medical cost management.
Role type
Medical Claim Analyst
Builds
Medical claims adjudication and cost management processes
Domain
Health insurance / Medical claims
Required skills
Problem solving, decision-making, multitasking, prioritization, adherence to protocols and standards
Preferred skills
None stated
Technologies
ECHS reports, CS Hub, CORR tasks
Responsibilities
Execute routine and non-routine business support tasks for the Medical Claims area; Review ECHS reports for task distribution; Review provider coding edits and prepare for clinician review; Process predetermination requests; Process CORR tasks; Balance projected workload and due dates.
Seniority
Mid-level, limited supervision