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BJC HealthCare

Saint Louis, Missouri

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Northeast Georgia Health System

Gainesville, Georgia

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Nicklaus Children’s Health System

Miami, Florida

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Baylor Scott & White Health

Fort Worth, Texas

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BJC HealthCare

Saint Louis, Missouri

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Baylor Scott & White Health

College Station, Texas

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CHRISTUS Health

Houston, Texas

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Nemours

Pensacola, Florida

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Baylor Scott & White Health

Dallas, Texas

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Beebe Healthcare

Rehoboth, Delaware

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Baylor Scott & White Health

Temple, Texas

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WMCHealth

Poughkeepsie, New York

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CHRISTUS Health

Shreveport, Louisiana

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Baylor Scott & White Health

Irving, Texas

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Baylor Scott & White Health

College Station, Texas

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WMCHealth

Valhalla, New York

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WMCHealth

Valhalla, New York

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CHRISTUS Health

Alexandria, Louisiana

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Foundation Health Partners

Fairbanks, Alaska

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Baylor Scott & White Health

Temple, Texas

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Claims Adjustment Anlst
JOB SUMMARYThe Claims Adjustment Analyst performs extensive reviews on member or provider claim issues to calculate root cause research. Researches and investigates previously paid or denied claims to correctly apply benefit determination and pricing in accordance with claims processing guidelines.ESSENTIAL FUNCTIONS OF THE ROLEPerforms extensive reviews on member or provider claim issues to learn root cause research. Documents, tracks, resolves and reports findings. Provides professional assistance to other staff, members and providers by researching and resolving claims payment issues resulting from configuration or processing errors. Follows up with appropriate department to resolve front


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