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Description
How long have you been in the Health Industry? Please read the following description. If you have the experience and requirements for the position, please contact Jeannine Sayegh in the Scottsdale office!
Detailed knowledge of health benefits.
Detailed working knowledge of claims administration, benefits, medical terms, pricing logic and medical and dental procedure codes (ICD9).
Ability to quickly understand system interfaces. (Benefit File, Membership, Claims Adjudication, Procedure File, Pricing File, Diagnosis File)
POSITON OVERVIEW:
Under general direction develops benefit programs which support new business benefit structures, new and renewed, benefit changes and benefit file efficiencies.
Identifies and evaluates business needs related to automated benefit adjudication. Responds to inquiries regarding benefit processing discrepancies. Develops system requirements, details specifications to meet business needs. Writes and executes test scripts and implements system changes in compliance with project specifications.
Acts as a liaison between customer and technical solutions/support groups to identify business processes, systems, and product requirements.
Considers the business implications of the application of technology to the current business environment.
PREREQUISITES:
Have two to three years progressive experience in systems development or business system analysis within the health care industry.
Working knowledge of health care benefit adjudication rules and system development experience.
Ability to respond to customer problems.
Produce high quality work that is thorough, accurate and timely.
Ability to maintain accurate records and meet reporting deadlines.
Strong organizational and follow-up skills.
Effective writing and communication skills.
Some background on the payer (insurance or TPA) side, especially in customer service or claims preferred...
Please contact Jeannine Sayegh
Apply Here
Salary: 45000 - 55000
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