Claims System Analyst
ISSG, Inc. - Information Systems Services Group - St. Louis, MO

This job posting is no longer available on JobServe USA. Find similar jobs: Claim System Analyst jobs - ISSG jobs

Medical Claims System Analyst:

Looking for a candidate who has an in depth knowledge of the full adjudication of Medical Health claims. This candidate must be able to help in providing knowledge and direction to IT/Claims Operations on standards and practices of being able to fully adjudicate a Medical Health Claim.

The candidate must possess the following skills and knowledge of such:
  • Complete understanding of Adjudication of Medical Health Claims.
  • Third Party Liability(TPL)/Coordination of Benefits(COB)
  • Medical Code Sets
  • Understanding of Vision, Transportation, & DME claims
  • Understanding of NCCI editing
  • Clear understanding of medical benefit structures.
  • Excellent written skills and oral communication skills
  • Excellent Analytical Skills and able to define business requirements.
  • Minimum of 5 years experience
  • In Depth knowledge of Medicare/Medicaid regulations.
  • Understanding of Pricing and Authorizations
  • Personality that is able to speak up and give direction

JobServe USA - 23 months ago - save job