Claims Analyst II

Claims Analyst II

Network Health's success is rooted in its mission to create healthy and strong Wisconsin communities. This mission drives the decisions we make, including the people we choose to join our growing team. We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role, you will determine whether to return, pend, deny, or pay claims in accordance with established policies and procedures.

Key responsibilities of this position include the following :

• Adjudicate claims by following departmental policies, operating memos, and corporate guidelines.
• Resolve claims and related issues in compliance with policy provisions.
• Compare claims applications and provider statements with policy files and other records to ensure completeness and validity.
• Process payments for claims that are approved.

This position plays a vital role in ensuring accurate and efficient claims processing, contributing to the overall success of Network Health.

Job Responsibilities :

Other Experience and Qualifications :

Application Instructions :

Apply online.