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Nicklaus Children’s Health System
Miami, Florida
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Veterans Affairs, Veterans Health Administration
Cedar Rapids, Iowa, Iowa
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Veterans Affairs, Veterans Health Administration
Beckley, West Virginia, West Virginia
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Claims Adjustment Analyst
JOB SUMMARY:The Claims Adjustment Analyst supports the review and closure of payment disputes including: corrected claims, retro authorizations, and incorrect denial requests in a timely manner. This position is responsible for processing medical claims, using industry standard practices for medical claims processing. The Claims Adjustment Analyst applies relevant rules and regulations specific to coding, providers, plan benefits, contracts, state and federal guidelines as well as Community Health Choice?s policies and procedures. JOB SPECIFICATION:30% Complete adjustment review requests 20% Application of established payment methodologies
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