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Claims Analyst I

Company: FirstCare Health Plans
Location: Austin
Posted on: January 14, 2019

Job Description:

SUMMARY: Under direct supervision, this position performs the activities involved in handling the process of moderate to complex claims, including COB (Coordination of Benefits), in accordance with company policies and procedures in a timely manner while meeting or exceeding production and quality standards. ESSENTIAL DUTIES and RESPONSIBILITIES:

  • Resolves outstanding holds in accordance with designated standards
  • Maintains employee/insured confidentiality
  • Participates in training programs as requested
  • Identifies areas of concern that may compromise client satisfaction
  • Openly participates in team meetings, provides ideas and suggestions to ensure client satisfaction, and promotes teamwork
  • Maintains mail date integrity
  • Assists other departments during periods of backlogs
  • Effectively prioritizes and completes all assigned tasks
  • Processes claim inquires by resolving various claim errors in accordance with designated standards
  • Performs other duties as assigned EDUCATION AND EXPERIENCE, SKILLS, CERTIFICATES, LICENSES, AND/OR REGISTRATIONS:
    • High school diploma or equivalent
    • 1 or more years of claims processing and or equivalent education/experience required
    • Knowledge of medical terminology, ICD-9, and CPT coding required
    • Ability to demonstrate organizational, interpersonal, and communication skills
    • Ability to maintain designated production and quality standards
    • Competent in MS office and PC skills
    • Working knowledge of COBFirstCare Health Plansis an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, genetics or any other basis prohibited by law.

      Keywords: FirstCare Health Plans, Austin , Claims Analyst I, Professions , Austin, Texas

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