Working remotely, the full-time Reimbursement Analyst II will manage full claim overpayment analysis, assist in identifying claims paid in error, and audit paid claims data using various tools and regulations. Key responsibilities Utilizes CMS, state, and client billing policies to identify claim overpayments with limited oversight Participates in reviewing paid health insurance claims and member eligibility to uncover overpayment trends Collaborates with data miners and stakeholders to track and document overpaid claims and communicate results Required qualifications 4-6 years of healthcare reimbursement experience, including claims analysis and auditing Demonstrated knowledge of healthcare claims processing for Medicaid, Medicare, and commercial insurance Experience applying healthcare guidelines such as CMS regulations to claims data Excellent analytical and time management skills Knowledge of Medicaid, Medicare, and commercial policy and reimbursement preferred
Reimbursement Analyst II in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.