Senior Claims Analyst - Riverside California

Company: VirtualVocations
Location: Riverside, California
Posted On: 02/05/2025

A company is looking for a Senior Claims Analyst to manage and process healthcare claims efficiently.



Key Responsibilities

Review and analyze healthcare claims for accuracy, completeness, and eligibility
Ensure claims are processed in accordance with company policies, procedures, and regulatory requirements
Investigate and resolve denied or rejected claims while maintaining organized records of claims and correspondence


Required Qualifications

Associate's or Bachelor's degree in Healthcare Administration, Business, or a related field preferred
Minimum of 5 years of experience in healthcare claims processing or a similar role
Strong knowledge of institutional claims processing, including inpatient and outpatient claims
Experience in repricing and pricing claims based on provider contracts and regulatory guidelines
Familiarity with medical terminology, claim coding (ICD, CPT, HCPCS), and insurance billing practices More...

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