The purpose of this position is to audit all claim types in accordance with Phoenix Health Plan and Abrazo Advantage Health Plan policies and procedures to determine if the Claims Department’s quality and timeliness standards are being maintained.
This individual also helps identify training needs and assists with compiling summary audit reports for internal departments and EMC.
Soundly familiar with managed care and have a working understanding of the operations of a claims department.
Must be highly organized, professional, and have excellent written and verbal communication skills.
Proficient in ICD-9, CPT, and HCPCS coding; strong numeric and analytical skills required. Proficient with claim processing systems and have the ability to use Microsoft office based applications as well as navigate proficiently on a personal computer.
A minimum of a High School diploma or equivalent is required.
Three years prior experience as a claim analyst.
Three years as a claim analyst and two or more years of experience working with audit functions in a managed care or health insurance environment.
Abrazo Health Care
- 2 years ago - save job
Abrazo Health Care is an award-winning health care system, operating an array of hospitals, specialty institutes, a medical group, health...