Were seeking an energetic, motivated member to join our team in Williston, VT. This position is a Medical Claims Analyst. The primary role of the analyst is to make decisions on payment of medical claims using existing policy and rules. Our ideal candidate will have a minimum of 1 year in a healthcare-related field. Are you a motivated, independent self-starter? Do you have strong verbal and written communication skills? Are you interested in learning about how state-provided healthcare programs operate in Vermont? This position offers full benefits including flexible vacation in order to ensure a work-life balance that supports a highly motivated team. \u2018By taking this position, youll be doing your part to ensure access to healthcare for Vermonters most in need.
Essential Job Functions
* Review and research suspended medical claims and adjudicate them per Department of Vermont Health Access policy.
* Refer claims to Utilization Review and provider services unit.
* Maintain necessary documentation.
* Participate in client meetings as necessary.
* Participate in process improvement sessions.
* Train as a back-up for other areas such as document control, courier and customer service help desk.
* Other duties as assigned.
* High School Diploma or equivalent
* Proficiency in Microsoft Excel, Word, and Outlook
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Job ID: 57006163
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