Reimbursement Analyst II

A company is looking for a Reimbursement Analyst II, responsible for full claim overpayment analysis in a remote setting. Key Responsibilities Conducts claim overpayment analysis using CMS, state, and client billing policies Reviews paid health insurance claims and member eligibility to identify overpayment trends Collaborates with data miners and clinical staff to audit claims and document findings Required Qualifications 4-6 years of healthcare reimbursement experience, including claims analysis and auditing Demonstrated knowledge of healthcare claims processing (Medicaid, Medicare, Commercial Insurance) Experience applying healthcare guidelines and regulations to claims data Excellent analytical and time management skills Knowledge of Medicaid, Medicare, and Commercial policy preferred

Apr 25, 2025 - 01:42

A company is looking for a Reimbursement Analyst II, responsible for full claim overpayment analysis in a remote setting. Key Responsibilities Conducts claim overpayment analysis using CMS, state, and client billing policies Reviews paid health insurance claims and member eligibility to identify overpayment trends Collaborates with data miners and clinical staff to audit claims and document findings Required Qualifications 4-6 years of healthcare reimbursement experience, including claims analysis and auditing Demonstrated knowledge of healthcare claims processing (Medicaid, Medicare, Commercial Insurance) Experience applying healthcare guidelines and regulations to claims data Excellent analytical and time management skills Knowledge of Medicaid, Medicare, and Commercial policy preferred