Medical Claims Analyst

Job Description

The Medical Claims Analyst will be responsible for accurately analyzing and processing medical claims. They will ensure compliance with industry regulations while handling claims efficiently and resolving discrepancies as they arise.

Responsibilities

• Review and analyze medical claims to ensure compliance with policy guidelines.
• Identify trends in claims data and help develop strategies for improvement.
• Adhere to company protocols and standards for claims processing.
• Provide training and support to junior analysts and new team members.
• Utilize claims management software effectively to track and manage claims.
• Conduct periodic audits of claims processed to maintain quality standards.

Requirements

Education

• Bachelor's degree in a related field
• Relevant certifications in claims processing or medical coding are a plus

Experience

• At least 2 years of experience in medical claims analysis or a similar role

Technical Skills

• Medical Coding Knowledge
• Claims Management Software

Soft Skills

• Problem-solving
• Organizational Skills

Languages

• English: Fluent