Northwell Health Analyst, Claims - CareConnect in Greenvale, New York

Req Number 0013QX

Job Category Non-Clinical Professionals

Job Description

1. Performs root cause analyses to identify claims issues related to processing and configuration, and works with management to develop and implement correction plans.

2. Researches, processes, resolves and coordinates responses to customer inquiries and correspondence.

3. Assists claims management in monitoring vendor claim processing and reporting to ensure quality and production metrics are consistently met.

4. Prepares and presents reports for management, clients or others on claim activity – daily, weekly, monthly, yearly.

5. Participates with claims management to develop and implement quality metrics and improve business processes.

6. Performs and/or reviews impact analyses of claim issues, reports such impacts to management.

7. Ensures processes and procedures are compatible with system functionality and internal customer requirements.

8. Performs quality audits of claims data as required

9. Maintains current knowledge of required systems, procedures, forms and manuals as related to claim processing.

10. Performs related duties, as required.

Qualifications

· Bachelor’s Degree in Business Administration or related field, required.

· Minimum one (1) year health insurance experience required, including working knowledge of claims processing and understanding of billing and claims data.

· Intermediate knowledge of excel, including pivot tables, required

· Excellent interpersonal, communication and writing skills, required.