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Claims Analyst
Claims AnalystLancesoft • Detroit, MI, US
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Claims Analyst

Claims Analyst

Lancesoft • Detroit, MI, US
30+ days ago
Job type
  • Full-time
  • Quick Apply
Job description

Job Description:
  • Primary responsibility includes working closely with external customers who submit 834 membership files. Knowledge of the 834 HIPAA compliant file layout is highly desirable.
  • Apply, analyze, and manage 834 and membership business rules. Manage email and phone inquiries from external customers related to 834 customer inquiries.
  • Analyze, process and/or expedite operational membership transactions;this may include timely resolution of problems. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process. Provide leadership team with status of issues.
  • Utilize and maintain available corporate production and reporting systems;produce routine and non-routine reports, letters, and communications. Assist personnel (both internal and external) by answering questions and supplying information.
  • Develop and maintain an effective working relationship with customers or partners.
Requirements
  • Bachelor’s Degree in related field preferred.
  • Demonstrated knowledge/competency in the following areas: membership inquiry or claims processing experience preferred, analytical experience, ability to produce statistical information from conceptual needs, and working with PC application and/or mainframe systems preferred.
  • Effective verbal and written communication skills.
  • At least two (2) years of healthcare enrollment, membership/billing experience preferred.
  • Working knowledge of Facets, EOS OR Macess considered a must
  • Knowledge of the 834 HIPAA compliant file layout is highly desirable.
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Claims Analyst • Detroit, MI, US

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