The Claims Analyst is responsible for reviewing, analyzing and processing medical and/or dental claims. This role is responsible for analyzing claims from first submission and processing them to the final payment while maintaining complete accuracy, production and quality standards.
Responsibilities
Analyzing/Processing
- Gain and maintain the understanding of the plan designs and effectively apply that knowledge.
- Analyze claims as appropriate from first submission to finalizing.
- Maintain complete and accurate processing.
Teamwork
- Work cooperatively with other team members
- Actively participate in team meetings and training activities.
- Perform additional responsibilities and projects as periodically assigned.
Qualifications
Education/Certification:
- (Minimum) High School Diploma/GED
- Three (3) years recent experience processing medical claims
Skills/Abilities:
- Ability to maintain production and quality standards.
- Extensive knowledge of medical terminology, CPT Codes, ICD 9/10 and medical claim forms.
- Ability to read, analyze and assess medical documentation and draw valid conclusions.
- Minimum 40 WPM and 3,000 KPH proficiency
- Solid knowledge of MS Excel & MS Word (i.e. pivot tables and lookup functions).
- Professional, client-focused approach to colleagues and assignments.
- Strong oral and written communication skills with exceptional attention to details.
- Ability to seek out experiences that may change perspective or provide an opportunity to learn new things.
- Strong dedication to follow-through on all tasks and assignments.
- Ability to organize, set priorities, work independently and complete multiple projects within established deadlines.
- Ability to sit for long periods of time operating a computer keyboard.
Employee Benefits Program
COMPANY PROVIDES:
- MEDICAL, DENTAL, VISION
- SHORT-TERM DISABILITY
- Full coverage benefits for a low weekly premium of $5 (Employee Only), $15 (for Child(ren) and $20 per week for full family or Employee/Spouse.
- COMPANY PAID supplemental dental coverage of $1,000 per year for Employee.
- COMPANY PAID LONG TERM Disability & Life/AD&D coverage.
- 401K Plan including company match up to 5%.
- COMPANY PAID additional pension plan entirely funded by the company.
- EXCEPTIONAL TIME OFF package including Paid Personal Leave (PPL) and Vacation with annual BUY BACK options!!!!
- Annual, automatic pay increases.
Southwest Service Administrators provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, pregnancy, military and veteran status, age, physical and mental disability, genetic characteristics, or any other considerations made unlawful by applicable state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence compensation and training. Southwest Service Administrators expressly prohibits any form of workplace harassment based on race, color, religion, sex, national origin, pregnancy, military and veteran status, age physical and mental disability, or genetic characteristics.
High school diploma/GED and 3 years of recent medical claims processing experience. Requires medical terminology, CPT and ICD-9/10 knowledge, Excel and Word proficiency, communication, organization, and keyboarding skills.
Key Responsibilities
- analyzing claims
- processing claims
- assessing documentation
Skills & Tools
Microsoft Excel, Microsoft Word
Job Details
- Category: Healthcare Services - Allied Health
- Seniority: Mid Level
- Commitment: Full Time
- Workplace: Remote — Phoenix, Arizona, United States
- Salary: USD 39,520 – 53,040 / year
- Languages: English
Benefits
- 401k matching
- Retirement plan
About Southwest Service Administrators Inc
A healthcare benefits administrator processing medical and dental claims. — Industry: Healthcare