Experienced in hospital claims adjudication, the full-time remote Senior Claims Analyst will analyze hospital bills and claims data to identify billing errors and negotiate claim adjustments on behalf of ASO clients. Key Responsibilities Perform detailed audits of hospital claims to validate billing accuracy and identify discrepancies Review high-cost claims to uncover overpayments and negotiate adjustments with claims administrators Analyze claims data to identify trends and maintain tracking logs of recovered savings Required Qualifications Hospital/Surgical/ICU Nursing background (RN) with clinical coding experience 5+ years of experience in hospital claims analysis and payment integrity Strong knowledge of DRG methodology, UB-04 billing, and related coding systems Understanding of stop loss insurance and its implications for claim adjustments Experience negotiating with TPAs or insurance carriers on disputed claims
Senior Claims Analyst in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.