Claims Processing Analyst I

Claims Processing Analyst I performs claims analysis and related tasks in support of claims administration under supervision. Responsibilities include claim review of simple to moderate complexity, provider contract pricing, independent analysis, assistance with special projects, validating submitted claims data for accuracy and integrity, analyzing pending claims with internal partners, prioritizing tasks to meet quality standards, identifying improvement opportunities to enhance efficiency and quality, participating in team meetings to promote best practices and teamwork, maintaining privacy and confidentiality, maintaining performance standards, supporting review, investigation, and research of claims issues, communicating effectively in verbal or written form, and adhering to Health System and Health Plan policies. Requires experience with Excel/Word, medical terminology, coding and billing concepts, health insurance and managed care principles, ability to work independently or in a team, and strong integrity and discretion. Located in Corpus Christi, TX with in-person work expectations.