Insurance Claims & Customer Service Analyst (Full-time, Monday - Friday, 8:00am-4:30pm)
On-siteFayetteville, Arkansas, United States
Job Summary
Review and audit medical claims for accuracy, completeness, and compliance with policy terms, legal requirements, and company procedures. Gather missing information from patients and healthcare providers, analyze claim data to identify trends, and apply contract provisions to determine claim payability. Serve as the primary point of contact to resolve claim-related issues, communicate stakeholder decisions, and prepare reports on claims volume and savings. Submit insurance authorizations efficiently while maintaining accurate records and adhering to HIPAA and 501r regulations. This role supports the Billing Manager in optimizing departmental policies and improving overall claims processing within Washington Regional Medical System's 425-bed medical center.
Required Qualifications
- High school diploma or GED
- Previous experience in a medical office setting
- Knowledge of healthcare insurance protocols
- Proficiency with computer systems
- Proficiency with electronic claims processing systems
- Proficiency with Microsoft Office Suite
- Strong analytical skills
- Strong problem-solving skills
- Strong communication skills
- Proficiency with medical codes (like ICD-10/CPT)
Desired Qualifications
- Associates degree in related field
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