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Claims Analyst in Latham, NY at Beacon Health Options

Date Posted: 12/5/2018

Job Snapshot

Job Description

About the Position:

We are currently seeking a dynamic Claims Analyst to join our team in Latham, NY! This position is a fast-paced and technical role. The CA is the primary lead on claims and system-related testing. The position monitors, performs analysis and completes adjudication of complex claims on daily, client-specific reports.

Position Responsibilities:

  • Process complex professional and institutional claims or those claims that require additional research and resolution, including but not limited to, adjudication and/or adjustment of expedited/priority issues
  • Review and complete daily client reports under Claims Leadership direction
  • Work in collaboration with management to proactively identify client service improvement opportunities and resolve claims-related challenges
  • Contribute to a team environment by consistently exhibiting interpersonal skills, promoting a positive and motivating work environment, displaying flexibility with daily operations/functions
  • Respond to processor adjudication and claims process questions throughout the day.  Advise processors on the calculation of complicated payment rates, payment of inpatient claims, etc.
  • Work closely with the Leadership team to ensure expedited/priority claims are assigned and adjudicated appropriately
  • Advise the Manager of any policies and procedures needed to support the unit
  • Perform other job related duties as dictated by business needs, as determined by management
  • May be required to work mandatory additional hours when business needs dictate

Position Requirements:

  • Education: High School diploma or GED equivalent is required, a college degree is preferred
  • Licensure: Certified Coding Certificate is preferred
  • Relevant Work Experience: 1 years of claims processing experience in a health care or managed care environment is required, 2 years of internal claims processing experience is preferred
  • Knowledge, Skills, &Abilities:
    • Strong computer skills and excellent keyboarding required.
    • Proficient with Microsoft Word and Microsoft Excel.
    • Ability to function within a team structure, focus on singular tasks, read and interpret workflow and procedure instruction and sit for long periods
    • Strong attention to detail and basic math skills

To Apply:

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled

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