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Baylor Scott & White Health

Cedar Park, Texas

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Baylor Scott & White Health

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Mckinney, Texas

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Baylor Scott & White Health

Leander, Texas

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Dallas, Texas

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Northeast Georgia Health System

Gainesville, Georgia

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Memorial Sloan Kettering Cancer Center

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Duke University Health System

Durham, North Carolina

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Braselton, Georgia

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CHRISTUS Health

San Antonio, Texas

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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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