Medical Claims Analyst at TEKsystems

Description:

1. Identify, develop and implement cost saving opportunities.

2. Performs adjustments. (JAA and MCS)

3. Works Blue Cross JAA reports

4. Communicates with Anthem via emails regards to Claims status

5. Performs voids and reissues

6. Works JAA reconciliation reports

7. Splits RFF for Stoploss

8. Request provider/ member overpayments.

9. Oversees Third Party liability process.

10. Track error trends and provide feedback to appropriate departments.

11. Attends meetings and training sessions as required.

12. Maintains strictest confidentiality.

13. In the spirit of teamwork, employees are expected to follow any other job-related instructions

and to perform any other job-related duties as requested.

Additional Skills & Qualifications:

High School diploma/GED equivalent required.

Minimum of 2 years- experience in a managed care setting.

Experience Level:

Intermediate Level

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.