Claims Analyst Jobs in New York

Job Title: Medical Claims Analyst EmblemHealth Company: New York's Job Exchange Location: New York, NY Description: Medical Claims Analyst Register to View EmblemHealth Job Description The responsibilities of this position include: •Performs and documents root-cause analyses in order to determine underlying reasons for claim suspensions â?¢Conducts Medical & Hospital claims systems studies, recommends enhancements in methods, procedures and policies. â?¢Presents recommendations and specification in formal reports and presentations â?¢Supports the implementation and ongoing operational maintenance of Exceptions Reduction. â?¢Organizes user test cases, develops training material and facilitates departmental Informational sessions. â?¢Develops, modifies and issues workflows, claims policies and procedures based on new/revised policies, new legislation via our online Instructional Repository, and Microsoft Office. Performs analytical review of claim reconciliation files received from Provider Groups/Hospitals, verifying claim dispositions and outcome. â?¢Monitors and documents post-settlement adjustments and file reconciliations â?¢Work with BTS and IT in matters relating to Medical & Hospital system logic. Skills and Abilities: â?¢Strong communication skills (written and verbal) •Demonstrated ability to conduct research, analyze data, categorize and report findings and determine operational needs â?¢Ability to multi-task in a fast paced environment with deadlines â?¢Outstanding conceptual and organizational skills The qualifications for this position are: â?¢Bachelorâ??s degree preferred â?¢Three (3) plus years of supervisory and/or training experience in a health care industry, customer service or claims environment â?¢Plus three (3) plus years in claims processing â?¢Strong knowledge of contracts, procedures and systems as well as medical terminology, ICD-9, CPT and HCPS coding formats Job Benefits Dental Insurance Health Insurance Holidays Life Insurance 401K / Retirement Plan Sick Leave Vacation Vision Insurance Tuition Reimbursement Job Summary AJE Reference Number: 530069560 Job Title: Medical Claims Analyst Company: EmblemHealth Location: US - NY, New York, 10041 Job Start/End Date: not provided Job Type: Regular Job Classification: Full Time Hours/Week: 35 hrs/week Salary Range: not provided N/A Education: Bachelors Degree Required Degree/ Formal Training: not provided Required Licenses/ Certificates : not provided Experience: Mid-Career (2 - 15 years) Company Homepage: http://www.emble... More Information