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Job details

Claims Analyst

Req # 00066897

Community First Health Plans
Claims
Day Shift

POSITION SUMMARY/RESPONSIBILITIES
Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff in complex claim issue resolution. Work cooperatively with Configuration in testing of contracts used in business operations and reporting to assure auto adjudication. Perform in accordance with company standards and policies. Promote harmonious relationships within own department, with other departments and within CFHP. Operate under limited supervision.

EDUCATION/EXPERIENCE
High school diploma or GED equivalent is required. Five years HMO/PPO claims experience required. Amisys claims processing system experience preferred. Knowledgeable of all benefit programs offered by the CFHP, Medicaid, HMO, PPO, ASO.

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CEO of University Health System
University Health System CEO photo
George B Hernández Jr.
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If University Health System had been around in 1836, maybe the Battle of the Alamo would have ended differently. The hospital system of the Bexar County Hospital District, University Health System serves the residents (and rebels) of San Antonio a...

21 jobs
TEAM SIZE
DATE POSTED
June 10, 2023

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