Senior Claims Analyst

Senior Claims Analyst page is loaded## Senior Claims Analyst locations:
Corpus Christi, TXtime type:
Full time posted on:
Posted 2 Days Agojob requisition :
JR110814#
**** Where compassion meets innovation and technology and our employees are family.
***** Thank you for your interest in joining our team! Please review the job information below.
** Analyze highly complex claims and claim issues to ensues to ensure correct claims payment, partner with Claims Administration and staff and health plan business partners for resolution.
* Identify trends and recommend solutions for errors as identified through pre- and post-payment claim and recover review.
* Assist with department leadership to develop daily inventory plans based on available resources, priority, and timeliness requirements.
* Analyze provider correspondence and requests for review to determine correct outcomes and resolution, escalating high priority/risk issues to leadership.
* Lead departmental projects and/or operational improvement initiatives.
* Assist in the examination, assessment, and business documentation of operations and procedures to ensure data integrity, security, and process optimizations.
* Ensure adherence to state and federal compliance, reimbursement and contract policies.
* Provide mentoring and coaching to team members, provide assistance and feedback to less experienced staff members, and lead training efforts for new employees.
* Openly participate in team meetings, providing ideas and suggestions to ensure departmental efficiency and quality, and to promote teamwork.
* Maintain required compliance with privacy and confidentiality standards.
* Maintain or exceed all established standards for performance, quality and timeliness.
* Demonstrate business practices and personal actions that are ethical and adhere to all Health System and Health Plan policies and procedures.
* Assist with other related work responsibilities as requested.
** Education and/or

Experience:

- *** Minimum five years professional experience in claims analysis , provider medical billing, or medical coding experience with Texas Medicaid preferred.
* Minimum two years professional experience with Claim research, adjustment and recover; experience with Texas Medicaid preferred.
* Minimum High school graduate or GED required.
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