[Remote] Electronic Claims Analyst

Note: The job is a remote job and is open to candidates in USA. HCA Healthcare is committed to caring for patients with purpose and integrity, and they are seeking an Electronic Claims Analyst. The role involves processing electronic claims, resolving related issues, and improving data integrity through various responsibilities.

Responsibilities

• Upload and process electronic claims
• Perform e-claim analysis that may have financial impact to the business
• Research and correct electronic claims related issues within Data Management
• Work with the Claims and Network Services Departments to resolve discrepancies with provider billing issues, such as Tax ID numbers, incorrect usage of NPI numbers, and Vendor addresses
• Work error reports produced by electronic load of claims data
• Correspond with providers regarding billing procedures to facilitate proper processing of e-claims
• Interface with users and technical staff for data entry and electronic claims issues
• Keep Data Management Manager informed of system and operational issues
• Lead projects for process improvement, reporting, infrastructure changes, new report definitions, etc
• Provide technical assistance, training, and direction to electronic claims staff
• Participate in testing new claims requirements and processes in conjunction with other departments
• Develop, document, and manage workflows for electronic claims
• Provider back-up and assistance for Excelicare data loads
• Perform other duties as assigned

Skills

• Excellent written and verbal communications skills
• Demonstrated analytical skills with ability to review information to determine appropriate action and define and resolve problems
• Ability to work independently and to prioritize tasks
• High School Diploma
• One year equivalent work experience required
• Experience maintaining member files
• Claims experience and or knowledge of claims processes
• Experience in a Health Insurance environment

Benefits

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Company Overview