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The Claim Field Analyst acts as the primary resource for groups and providers, within a specific geographic location, to establish, oversee, and maintain a proactive claim education program focused on assisting providers with claim denials, claim education, and claim resolution. This position works with providers to improve claim submission and payments through training and education.
Job Responsibility:
Act as primary resource for groups and providers to establish, oversee, and maintain proactive claim education program
Analyze claim denials to track and trend potential opportunities
Assist in creating bulletins, newsletters, and claim trainings to improve provider claims issues and billing practices
Collaborate with internal and/or external departments to identify claim training and education opportunities
Develop, implement, support, and promote provider training strategies
Work with grievance and appeal and claims operations department to trend provider claim issues
Meet regularly with assigned providers to conduct trainings and education
Respond to assigned provider claim questions or inquiries
Requirements:
3+ years of experience in medical billing and coding, specifically related to claims processing and root cause analysis
3+ years of experience with provider engagement/relations
Working proficiency of Microsoft Office products (Word, Excel, PowerPoint, Outlook)
Advanced experience in Microsoft Excel for data mining
Must reside in Central Florida - Tampa (Region D - Hardee, Highlands, Hillsborough, Manatee, Polk) and/or Orlando (Region E - Brevard, Orange, Osceola, Seminole)
Ability to travel 70% of time within Central Florida
Ability to work Monday-Friday from 8am-5pm EST, with the flexibility to work beyond core hours as needed
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