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Claims Analyst job in Williston at Gainwell

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Claims Analyst at Gainwell

Claims Analyst

Gainwell Williston, VT Full Time
Job Description:

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.

Qualifications

  • * High School Diploma or equivalent
  • * Proficiency in Microsoft Excel, Word, and Outlook
  • * Oral and written communication skills
  • * Attention to detail

 

Recommended Skills

Verbal Communication
Written Communication
Attention To Detail
Microsoft Access
Documentation
Microsoft Outlook

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