What are the responsibilities and job description for the Medical Claims Analyst position at Maxonic, Inc.?
Job Title : Claims/Denials Analyst
Client Name: Eisenhower Medical Center
Location: Rancho Mirage, CA
Duration: 3 months(Possibility for extension)
Rate: $26/hr on w2
Job Description:
- Responsible for researching and resolving claim denials, ADR requests and certs, submitting and tracking appeals, noting trends and providing monthly reports. Responds to audit requests (including RAC) from payors. Maintains a Library of Payer reference material regarding requirement for pre authorization, medical necessity and documentation requirements. Works with the Revenue Cycle stakeholders (e.g. Admitting, Coding, Provider Liaisons, etc.) to provide information related to denials and opportunities for future denials.
Essential Responsibilities
1. Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations
2. Analyze denied, underpaid and unpaid claims. Appeal underpaid and denied claims within timely filing periods
3. Identify, track and report on denial trends
4. Maintain an appeals data base to identify and report outcomes and opportunities
5. Identify any billing and/or coding trends resulting in denials and report to the Coding manager
6. Identify any other trends resulting in denials and report to Manager.
7. Attend all available coding and appeals related seminars as available
8. All other duties as assigned
Job Type: Contract
Pay: $25.00 - $26.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- Monday to Friday
Experience:
- ICD-10: 1 year (Preferred)
Ability to Commute:
- Rancho Mirage, CA 92270 (Required)
Ability to Relocate:
- Rancho Mirage, CA 92270: Relocate before starting work (Required)
Work Location: In person
Salary : $25 - $26
