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POSITION SUMMARY/RESPONSIBILITIES
Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff in complex claim issue resolution. Work cooperatively with Configuration in testing of contracts used in business operations and reporting to assure auto adjudication. Perform in accordance with company standards and policies. Promote harmonious relationships within own department, with other departments and within CFHP. Operate under limited supervision.
EDUCATION/EXPERIENCE
High school diploma or GED equivalent is required. Five years HMO/PPO claims experience required. Amisys claims processing system experience preferred. Knowledgeable of all benefit programs offered by the CFHP, Medicaid, HMO, PPO, ASO.
Full Time
$56k-72k (estimate)
05/06/2024
05/24/2024
uhsystem.com
SHREVEPORT, LA
1,000 - 3,000
2013
Private
STEPHEN SKRIVANOS
$200M - $500M
Hospital
University Health specializes in surgeries, life-saving care and complex treatments.
The following is the career advancement route for Claims Analyst positions, which can be used as a reference in future career path planning. As a Claims Analyst, it can be promoted into senior positions as a Claims Examiner IV that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Claims Analyst. You can explore the career advancement for a Claims Analyst below and select your interested title to get hiring information.