Claims Analyst

The Claims Analyst is responsible for reviewing, analyzing and processing medical and/or dental claims. This role is responsible for analyzing claims from first submission and processing them to the final payment while maintaining complete accuracy, production and quality standards.

Responsibilities

Analyzing/Processing

• Gain and maintain the understanding of the plan designs and effectively apply that knowledge.
• Analyze claims as appropriate from first submission to finalizing.
• Maintain complete and accurate processing.

Teamwork

• Work cooperatively with other team members
• Actively participate in team meetings and training activities.
• Perform additional responsibilities and projects as periodically assigned.

Education/Certification:

• (Minimum) High School Diploma/GED
• Three (3) years recent experience processing medical claims

Skills/Abilities:

• Ability to maintain production and quality standards.
• Extensive knowledge of medical terminology, CPT Codes, ICD 9/10 and medical claim forms.
• Ability to read, analyze and assess medical documentation and draw valid conclusions.
• Minimum 40 WPM and 3,000 KPH proficiency
• Solid knowledge of MS Excel & MS Word (i.e. pivot tables and lookup functions).
• Professional, client-focused approach to colleagues and assignments.
• Strong oral and written communication skills with exceptional attention to details.
• Ability to seek out experiences that may change perspective or provide an opportunity to learn new things.
• Strong dedication to follow-through on all tasks and assignments.
• Ability to organize, set priorities, work independently and complete multiple projects within established deadlines.
• Ability to sit for long periods of time operating a computer keyboard.

Employee Benefits Program

COMPANY PROVIDES:

• MEDICAL, DENTAL, VISION
• SHORT-TERM DISABILITY
• Full coverage benefits for a low weekly premium of $5 (Employee Only), $15 (for Child(ren) and $20 per week for full family or Employee/Spouse.
• COMPANY PAID supplemental dental coverage of $1,000 per year for Employee.
• COMPANY PAID LONG TERM Disability & Life/AD&D coverage.
• 401K Plan including company match up to 5%.
• COMPANY PAID additional pension plan entirely funded by the company.
• EXCEPTIONAL TIME OFF package including Paid Personal Leave (PPL) and Vacation with annual BUY BACK options!!!!
• Annual, automatic pay increases.

Southwest Service Administrators provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religio