Claims Analyst

Responsible for validating disputes on Explanation of Benefits (EOB), entering denied claim into the DMT database, and escalating payment variance trends to Management. Generates appeals for denied or underpaid claims, and coordinates with the Clinical Resource Center (CRC) for clinical consultations or account referrals when necessary.

Requirements

• HS/Diploma GED equivalent
• 2 years minimum in a Hospital or RCM environment performing billing / collections / disputes & claims research
• Strong payer knowledge & ability to identify trends
• Intermediate understanding of Explanation of Benefits form (EOB)
• Understanding of UB-04 / 1500 forms
• Medical terminology
• Intermediate Microsoft Office (Word, Excel) skills
• Advanced business letter writing skills
• Ability to multi-task and adapt to change

Benefits

• Competitive salary, negotiable based on relevant experience
• Medical, Dental, and Vision benefits
• Fun and positive work environment