Health Benefits Appeals Analyst Job Listing at MedStar Medical Group in Baltimore, MD (Job ID req41513)

Description

MedStar Family Choice is currently seeking a Health Benefits Appeals Analyst to join their team.  Position is remote but candidate must be local to the DMV area for on-site training and meeting requirements. 

As a Health Benefits Appeals Analyst, you will regularly communicate with both internal and external customers concerning benefit and fee schedule interpretation, NCCI (National Correct Coding Initiative) and other claims issues. Research incoming appeals and determines final resolution based on health plan policies and procedures. Uses knowledge of Medicaid rules and regulations, claims, appeals and managed care to explain procedures to vendors, providers and customers. Acts as a resource for claims, customer service, provider relations and other departments.

• Associate's degree in Healthcare Administration, Business Administration or related field required
• Bachelor's degree in Healthcare Administration, Business Administration, or related field preferred
• One year of relevant education may be substituted for one year of required work experience.

• 5-7 years Experience in the health care delivery system or insurance setting required
• Experience with managed care/claims, appeals experience including experience with insurance/managed care benefits and procedures for appeals and claims processing. required
• One year of relevant professional-level work experience may be substituted for one year of required education.

• Certified Professional Coder (CPC) preferred and Claims Appeals certification preferred

• Knowledge of all aspects of claims processing, auditing, coding, A/R and reporting (MicroSoft Excel and Access).
• Excellent verbal and written communication skills.
• Data mining and analytical skills.
• Ability to recognize, analyze, and solve a variety of problems.