Associate Analyst, Claims Research (Remote)-Triage

This is a Fully Remote Job
About Our Client:
This organization operates within the healthcare sector, focusing on medical claims processing and research. It addresses challenges related to timely and accurate resolution of provider-submitted claims issues, aiming to improve claims performance and compliance through analysis and process enhancements.
About the Opportunity:
The ASSOCIATE ANALYST, CLAIMS RESEARCH (REMOTE)-TRIAGE plays a key role in supporting claims research activities. The position is responsible for analyzing claims-related issues, efficiently triaging them to appropriate teams, and identifying trends to drive continuous improvements. This role contributes by ensuring accurate claims assessments and maintaining quality and production standards.
Responsibilities:
Review and analyze provider-submitted claims issues to identify root causes.
Triage issues based on type and complexity, assigning them for further research or correction.
Apply knowledge of claims workflows, billing practices, and regulations to assess claims accurately.
Meet established quality and production goals.
Maintain detailed records of claim reviews and resolutions.
Identify trends in claims issues to support process improvements.
Provide feedback and recommendations to enhance claims research processes.
Requirements:
Minimum of 1 year experience in medical claims processing, research, or healthcare operations, or equivalent education and experience.
Basic knowledge of medical claims processing.
Skills in data research and analysis.
Strong organizational skills and attention to detail.
Time-management abilities to handle multiple tasks and meet deadlines.
Customer service and problem-solving skills.
Ability to work independently and collaboratively in a matrixed environment.
Effective verbal and written communication skills.
Proficiency with Microsoft Office suite including Excel and relevant software.
Pay Range and Compensation Package:
The pay range and compensation package for this role will be determined based on the candidate's experience, skills, and other relevant factors.
Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.

Work arrangement
Yes