Medical Claims Analyst

The representative is responsible for collections, account follow up, billing and allowance posting for the accounts assigned to them.

Duties and Responsibilities

• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites.

• Meets and maintains daily productivity/quality standards established in departmental policies.

• Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts.

• Adheres to the policies and procedures established for the client/team.

• Knowledge of timely filing deadlines for each designated payer.

• Performs research regarding payer specific billing guidelines as needed.

• Ability to analyze, identify and resolve issues causing payer payment delays.

• Ability to analyze, identify and trend claims issues to proactively reduce denials.

• Communicates to management a...