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Memorial Hospital of Lafayette County

Darlington, Wisconsin

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Sonic Healthcare USA

Aiea, Hawaii

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University of Maryland Medical System

Aberdeen, Maryland

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Optum

Saint Petersburg, Florida

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Memorial Sloan Kettering Cancer Center

New York, New York

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Duke University Health System

Durham, North Carolina

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New York, New York

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University of Maryland Medical System

La Plata, Maryland

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Port Jervis, New York

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Northeast Georgia Health System

Braselton, Georgia

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Denver Health

Denver, Colorado

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Denver, Colorado

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Durham, North Carolina

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Vanderbilt Health

Nashville, Tennessee

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AdventHealth Greater Orlando

Tampa, Florida

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Northeast Georgia Health System

Gainesville, Georgia

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Trinity Health

Boise, Idaho

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Baylor Scott & White Health

Garland, Texas

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Dignity Health

Rocklin, California

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Denver Health

Denver, Colorado

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AdventHealth Greater Orlando

Daytona Beach, Florida

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Northwest Permanente, Kaiser Permanente Northwest

Portland, Oregon

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Vanderbilt Health

Nashville, Tennessee

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Claims Adjustment Anlst
JOB SUMMARYThe Claims Adjustment Analyst performs extensive reviews on member or provider claim issues to determine root cause analysis. Researches and investigates previously paid or denied claims to correctly apply benefit determination and pricing in accordance with claims processing guidelines.ESSENTIAL FUNCTIONS OF THE ROLEPerforms extensive reviews on member or provider claim issues to determine root cause analysis. Documents, tracks, resolves and reports findings. Provides expert assistance to other staff, members and providers by researching and resolving claims payment issues resulting from configuration or processing errors. Follows up with appropriate department


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