A company is looking for an Operations Analyst to assist with workflow distribution, claim research, documentation processing, and operational / service pilot projects in support of Clinical Review operations.
Key Responsibilities
Review and analyze claim appeals, coordinating with coders and assisting customers and providers with inquiries
Manage claim inventory for various billing types and process documentation for special projects
Perform data entry, database maintenance, and system claim adjustments while ensuring compliance with HIPAA regulations
Required Qualifications
Minimum high school diploma or GED with two years of experience in an operations / service role; Associate's degree accepted without prior experience
Experience in healthcare and knowledge of medical coding preferred
Required licensures, professional certifications, and / or Board certifications as applicable
Ability to use software and hardware related to job responsibilities, including MS Office Suites
Ability to work independently and handle confidential information in a standard office environment
Operations Analyst • Santa Ana, California, United States
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