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Healthcare Data Analyst
hace 1 semana
The Healthcare Appeals Analyst role is responsible for identifying under-allowed claims, analyzing and pursuing appeal opportunities with payers and networks, and reporting appeals performance.
Key Responsibilities:- Implement process for identifying under-allowed claims using software and other available tools.
- Review and analyze EOBs for identified under-allowed claims.
- Verify applicable contract by reviewing EOB messages, patient ID card, and member information for managed care plans.
- Use feedback and experience to refine communication skills and tools for preparing written and telephone appeals.
- Batch appeals by payer or network, CPT/HCPCS code combination, error type, or provider.
Required Skills and Qualifications:
- High School completed and some university studies preferred.
- Minimum one to two years' experience working with managed care claims and appeals for healthcare professional services (physicians and other healthcare professionals).
- Experience in a production environment desirable but comfort in such an environment essential.
- Equivalent combination of education and experience may be considered.
About Experian
We are proud to be an Equal Opportunity and Affirmative Action employer. We believe that diversity, equity, and inclusion are essential to our purpose of creating a better tomorrow. We value the uniqueness of every individual and want you to bring your whole, authentic self to work.
