Medical Claims Analyst
Core
Review and triage medical claims, verify eligibility, and prepare authorizations for medical staff review.
Role type
Medical Claims Analyst
Builds
Claims processing workflows and authorization management
Domain
Health insurance / Medical billing
Required skills
Medical terminology, Customer service, Computer literacy, Regulatory compliance, Documentation, Confidentiality
Preferred skills
Medical assistant experience, Claim processor experience, CEC/GPS or MedCompass certification
Technologies
Microsoft Office 365, Excel, Word, Teams, Outlook, EHR portal, VPN
Responsibilities
Initial review and triage of claims, Determine coverage and verify eligibility, Prepare authorizations in the system, Organize and prioritize work to meet turn-around times, Perform non-medical research, Maintain accurate documentation, Assist in resolving claims payment issues
Seniority
Entry to Mid-level, hands-on IC