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Job: Claims Analyst - Claims Processing - 503609
Posted: 01/26/2012
Job Status: Full Time
Job Reference #: 503609
Job Description
Category: Administrative/Clerical
Facility: Phoenix Health Plan/Abrazo Advantage Health Plan
Department: Claims Processing
Schedule: Full Time
Shift: Day Shift
Hours: 80
Job Details:
Overview: Support the Claims Department by processing claims for payment at the production, quality and timeliness levels determined appropriate. Job duties include:
Processes all assigned claims within the Analyst I category in addition to a minimum of 3 claim types in the Analyst II category in accordance with department standards for accuracy, productivity, and timeliness.
Checks procedure codes and diagnosis codes for correct billing procedures.
Denies all claims not submitted in the correct format or without required documentation.
Pends claims in accordance with Plan procedures. Processes pended claims after appropriate review.
Performs research on claim issues resulting from telephone calls and correspondence submitted by providers and other parties, including timely follow-up with originator of the research as needed.
Identifies and reviews unusual claims with Team Leader.
Special Skills: Proficient in ICD-9, CPT, and HCPCs coding. Strong data entry, 10-key and general numerical analytical skills required. Must be highly organized and able to work successfully in a team environment.
Minimum Requirements: High School/GED required. Minimum of one to three years of prior work experience preferably in healthcare as a claims analyst in a high volume computerized environment.
Preferred Qualifications: Previous claims experience in an AHCCCS environment is preferred.
~IND
Skills / Requirements
See Above
Application Instructions
To apply directly to Phoenix Health Plan/Abrazo Advantage Health Plan, please click the link below. Another window will open and allow you to apply directly online.
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