Medical Claims Specialist

A company is looking for a Medical Claims Analyst to assist in transforming primary care delivery and patient service. Key Responsibilities Process claims that pend for various hold reasons to assist in final determination on claim disposition Research complex claims issues and collaborate with other departments to resolve them Act as a subject matter expert on departmental and corporate projects related to claims Required Qualifications High school diploma or equivalent is required 5+ years of experience in claims processing for commercial and Medicare claims 3+ years of experience in researching and resolving operational issues Experience with EZ-CAP software is highly preferred Previous visibility into Medicare and Medicare Advantage programs is highly preferred

Mar 26, 2025 - 16:41

A company is looking for a Medical Claims Analyst to assist in transforming primary care delivery and patient service. Key Responsibilities Process claims that pend for various hold reasons to assist in final determination on claim disposition Research complex claims issues and collaborate with other departments to resolve them Act as a subject matter expert on departmental and corporate projects related to claims Required Qualifications High school diploma or equivalent is required 5+ years of experience in claims processing for commercial and Medicare claims 3+ years of experience in researching and resolving operational issues Experience with EZ-CAP software is highly preferred Previous visibility into Medicare and Medicare Advantage programs is highly preferred