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๐ค Closed by robot after apply link errored w/ code 404 11 months ago
\nCurative Health Holdings, Inc is searching for a claims analyst to review claims for completeness and process per plan guidelines. Carries out all duties while maintaining compliance and confidentiality and promoting the mission of the organization.\nESSENTIAL DUTIES AND RESPONSIBILITIES \n\n\nReviews claims for compliance with plan guidelines and approves or denies payment using established guidelines, policy and procedures and plan directives.\n\nDocuments clearly and concisely claims adjudication decisions in Claim Notes. Consults appropriate reference materials to verify proper coding.\n\n\n\n\n\nAbility to interpret and apply plan guidelines while processing to ensure correct plan setup.\n\n\n\n\n\n\n\nCoordinates adjudication of claims against the eligibility of individual enrollees as well as authorizations and benefit verification.\n\nProactively identify processes and system problems than can be improved, to reduce rework and provide accurate payment upon original processing.\n\nMaintains timely responses to appeals and reconsideration requests \n\nAttends and participates in departmental training, functions, and meetings.\n\nAbility to meet/ maintain the required accuracy and production standards after release from training.\n\n\n\n\n\n\n\n* Adheres to rules and regulations of Covenant Management Systems as described in the employee handbook and in the unit/department/clinic procedures\n\n\n\n\n\nPerforms other duties, functions and projects, as assigned, by team management.\n\n\n\n\n \n\nTravel Requirements: None\nREQUIRED EXPERIENCE \n\n\nAt least 3 years of experience in claims adjudication, including PPO and/or Medicaid. Experience with various claim payment systems in processing hospital, mental health, dental and routine medical claims within given deadlines.\n\nKnowledge of medical terminology, ICD-10, CPT, and HCPCS coding.\n\nWorking Knowledge of MS Access and Excel preferred\n\nExcellent computer and keyboarding skills, including familiarity with Windows\n\nExcellent interpersonal & problem solving skills.\n\nExcellent verbal and written communication skills in order to communicate clearly and effectively to all levels of staff, members and providers.\n\nAbility to be focused and sit for extended periods of time at a computer workstation. \n\nAbility to work in a team environment and manage competing priorities \n\nAbility to calculate allowable amounts such as discounts, interest and percentages \n\n\n\n\n \n\nREQUIRED EDUCATION, LICENSES and/or CERTIFICATIONS\n\n\nHigh school diploma or equivalent.\n\n\n\n\n\n\n \n\n#Salary and compensation\n
No salary data published by company so we estimated salary based on similar jobs related to Excel and Medical jobs that are similar:\n\n
$77,500 — $122,500/year\n
\n\n#Benefits\n
๐ฐ 401(k)\n\n๐ Distributed team\n\nโฐ Async\n\n๐ค Vision insurance\n\n๐ฆท Dental insurance\n\n๐ Medical insurance\n\n๐ Unlimited vacation\n\n๐ Paid time off\n\n๐ 4 day workweek\n\n๐ฐ 401k matching\n\n๐ Company retreats\n\n๐ฌ Coworking budget\n\n๐ Learning budget\n\n๐ช Free gym membership\n\n๐ง Mental wellness budget\n\n๐ฅ Home office budget\n\n๐ฅง Pay in crypto\n\n๐ฅธ Pseudonymous\n\n๐ฐ Profit sharing\n\n๐ฐ Equity compensation\n\nโฌ๏ธ No whiteboard interview\n\n๐ No monitoring system\n\n๐ซ No politics at work\n\n๐ We hire old (and young)\n\n
\n\n#Location\nAustin, Texas, United States
# How do you apply?\n\nThis job post has been closed by the poster, which means they probably have enough applicants now. Please do not apply.