Production Analyst

• Review and adjudicate all types of claims designated as “production claims,” meeting production and quality goals.
• Apply benefit plan rules and processing guidelines to pay, pend, or deny claims.
• Manage and follow up timely on all pending claims and correspondence, including review of patient claim history.
• Review and determine eligibility and coverage for specific group/plan.
• Research claim problems and take necessary actions to resolve.
• Utilize training and online documentation to keep up to date on processing guidelines, insurance principles, DOL rules and regulations, and benefit plan rules.
• Update claims system with applicable claim and patient notes.
• Contact employers, providers, participants, as necessary.
• Utilize Claim Workflow system for work assignments, routing, and follow up.
• Handle other claim-related duties, projects, and assignments as assigned, including handling of claim exceptions and provider not found claims.

Qualifications:

• One to two years of college or equivalent experience.
• Medical billing and/or AMA coding experience preferred.
• Data entry experience or equivalent type work using keyboard/PC.

This is a Union position.

Schedule:

• Monday to Friday

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance