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Medical Claims Analyst

Reading, PA 19601

Posted: 02/10/2025 Employment Type: Administrative Industry: ADMINISTRATIVE/CUSTOMER SERVICE Pay Rate: $22.14/hr

Job Description

Temp-to-Hire Medical Claims Analyst!

Schedule: Mon-Thurs 8am-4:30/5pm (once a week 11am/12pm-8pm), Fri 8am-4pm

Job Duties:

  • Communicate directly with rendering providers daily to acquire/confirm irregularities within service(s) documented in the EHR, via encrypted email.
  • Acquire knowledge of all Behavioral Health and Physical Health documentation workflows related to regulation/requirements
  • Review all services for accuracy on items such as duration, appropriate service type selection, and encounter form requirements.
  • Report, manage and follow up with any irregularities found to rendering providers within a timely manner, to ensure timely submission to the insurance carrier(s).
  • Utilizing the EHR, create to do item(s) for any rendering provider’s service(s) needing corrections/update.
  • Work collaboratively with all in house department(s) to ensure accuracy of all services rendered, assisting with the submission of a accurate claims.
  • Work collaboratively with billing lead to identify potential areas for risk control and assist with potential submissions.
  • Complete weekly follow up on all pending items to ensure timeliness of claim submission, including sending reminders for all pending items.
  • Process all clinical discharges for balances, including updating insurance tab.
  • Process initial screening of all clinical evaluations, including reporting any discrepancies to appropriate personnel

Requirements:

  • Bilingual Preferred
  • Associate’s degree in Business/Finance or Billing Certification (Certified Professional Coder (CPC) or Certified Billing Professional (CPB)) and minimum of three (3) years billing or coding experience in the Health Care Industry required
  • Computer and billing software program experience required
  • Strong MS Office experience

Interested in learning more about this exciting opportunity? Please send your resume to careers@gagepersonnel.com for consideration.

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About Reading, PA

Ready to kickstart your dream career in vibrant Reading, Pennsylvania? Embrace exciting job opportunities in this thriving city nestled in the heart of Berks County! Known for its rich history, diverse culture, and bustling arts scene, Reading offers an array of growth possibilities to job seekers. Explore job listings in this charming city and discover the allure of landmarks like the Pagoda, the captivating art collections at GoggleWorks Center for the Arts, and the engaging performances at the Santander Performing Arts Center. Indulge in local delicacies like the famous Philly cheesesteak and immerse yourself in the region's love for sports with the Reading Fightin Phils baseball team. Join us in exploring the endless possibilities awaiting you in Reading, PA.