Driscoll Children's Hospital
Claims Processing Analyst I
Driscoll Children's Hospital, Corpus Christi, Texas, United States, 78401
Where Compassion Meets Innovation And Technology And Our Employees Are Family
Thank you for your interest in joining our team! Please review the job information below. General Purpose Of Job: The Claims Processing Analyst performs claims analysis and associated responsibilities in support of claims administration and performs other related work as required. Essential Duties And Responsibilities: Validate submitted claims data to ensure accuracy, validity, and integrity. Analyze pending claims and collaborate with internal business partners for necessary information and assistance, according to departmental procedures. Effectively prioritize and complete all assigned tasks within appropriate timeframes and with the required level of quality. Evaluate claims issues and procedures to identify and suggest opportunities for improvement, both in efficiency and quality. Openly participate in team meetings, providing ideas and suggestions to ensure departmental best practices, and to develop and promote teamwork. Maintain required compliance with privacy and confidentiality standards. Maintain or exceed all established standards for performance, quality, and timeliness. Support the Claims department in review, investigation, and research of claims issues and completion of claims projects. Communicate effectively, in verbal or written form, by sharing ideas and reporting facts and issues. Demonstrate business practices and personal actions that are ethical and adhere to all Health System and Health Plan policies and procedures. Assist with other related work responsibilities as requested. Education And/Or Experience: Claims Analyst I Minimum of two years professional experience in claims analysis, provider medical billing, or medical coding. High school graduate or GED required. Experience with Microsoft Excel and Word, as well as with medical terminology, coding and billing concepts. Experience with health insurance and managed care principles. Ability to work independently, or in a team environment, toward meeting common goals. Integrity and discretion to maintain confidentiality of member and provider data. Ability to apply mid-level concepts of claims adjudication, following established procedures and workflows for completion of assigned tasks. Ability to multi-task and meet deadlines in a fast-paced environment. Claims Analyst II Minimum of five years professional experience in claims analysis, provider medical billing, or medical coding. Proficiency with Microsoft Excel and Word, as well as with medical terminology coding and billing concepts. Advanced experience with health insurance and managed care principles. Experience with complex claims analysis and resolution. Ability to work independently, or in a team environment, toward meeting common goals. Integrity and discretion to maintain confidentiality of member and provider data. Advanced analytical skills with ability to collect, organize, analyze and disseminate and communicate information with attention to detail. Ability to multi-task and meet deadlines in a fast-paced environment. Ability to access data in varied formats with different methods of analyzing and processing.
Thank you for your interest in joining our team! Please review the job information below. General Purpose Of Job: The Claims Processing Analyst performs claims analysis and associated responsibilities in support of claims administration and performs other related work as required. Essential Duties And Responsibilities: Validate submitted claims data to ensure accuracy, validity, and integrity. Analyze pending claims and collaborate with internal business partners for necessary information and assistance, according to departmental procedures. Effectively prioritize and complete all assigned tasks within appropriate timeframes and with the required level of quality. Evaluate claims issues and procedures to identify and suggest opportunities for improvement, both in efficiency and quality. Openly participate in team meetings, providing ideas and suggestions to ensure departmental best practices, and to develop and promote teamwork. Maintain required compliance with privacy and confidentiality standards. Maintain or exceed all established standards for performance, quality, and timeliness. Support the Claims department in review, investigation, and research of claims issues and completion of claims projects. Communicate effectively, in verbal or written form, by sharing ideas and reporting facts and issues. Demonstrate business practices and personal actions that are ethical and adhere to all Health System and Health Plan policies and procedures. Assist with other related work responsibilities as requested. Education And/Or Experience: Claims Analyst I Minimum of two years professional experience in claims analysis, provider medical billing, or medical coding. High school graduate or GED required. Experience with Microsoft Excel and Word, as well as with medical terminology, coding and billing concepts. Experience with health insurance and managed care principles. Ability to work independently, or in a team environment, toward meeting common goals. Integrity and discretion to maintain confidentiality of member and provider data. Ability to apply mid-level concepts of claims adjudication, following established procedures and workflows for completion of assigned tasks. Ability to multi-task and meet deadlines in a fast-paced environment. Claims Analyst II Minimum of five years professional experience in claims analysis, provider medical billing, or medical coding. Proficiency with Microsoft Excel and Word, as well as with medical terminology coding and billing concepts. Advanced experience with health insurance and managed care principles. Experience with complex claims analysis and resolution. Ability to work independently, or in a team environment, toward meeting common goals. Integrity and discretion to maintain confidentiality of member and provider data. Advanced analytical skills with ability to collect, organize, analyze and disseminate and communicate information with attention to detail. Ability to multi-task and meet deadlines in a fast-paced environment. Ability to access data in varied formats with different methods of analyzing and processing.