Medical Claims Analyst
Company: ActiveSoft, Inc
Posted on: January 16, 2022
Claims analysis and resolution
Provides cross functional support to key Operations projects as
Assists Manager with review and analysis of weekly Claims
Dashboard. Ensuring claims inventory is current.
Identifies patterns within Claims inventory and works with Claims
leadership and Claims TPA to resolve.
Leads provider calls as Claims SME
Works with Claims TPA on provider appeals
Works with CCA technical staff to help design/develop claims
Works with team, management, and self-directed to identify and
document benefits, costs and risks associated with business
Has a strong customer services focus and communicates status issues
and changes to appropriate audience.
Bachelor's Degree or equivalent experience
3 plus years of Claims experience
Advanced Excel skills
3 plus years of Medicare Advantage Experience
Medicare/ Medicaid working knowledge
SQL, Tableau, PowerPoint, OneNote experience
3rd party vendor experience
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Keywords: ActiveSoft, Inc, Boston , Medical Claims Analyst, Healthcare , Boston, Massachusetts
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