The Certified Corrected Claim Resolution Analyst will be responsible for researching and auditing
medical records for complex, diverse, multi-specialty provider claims to identify and determine
appropriately coded billed services when compared to the Zelis Claim Edits Product. The Certified
Corrected Claim Resolution Analyst is responsible for processing, escalating, routing, and
responding to complex incoming Client and Provider corrected claims and inquiries.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to
HR@insightglobal.com.
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https://insightglobal.com/workforce-privacy-policy/ .
3+ years of relevant experience or equivalent combination of education & work within healthcare
payer or provider.
Certified coder (CCS, CCS-P or CPC), or RN, LPN with coding certification is required.
Knowledge of healthcare reimbursement policies, state and federal regulations and applicable
industry standards.
Knowledge of correct coding and industry standard claim adjudication guidelines and policies.
Ability to translate coding and adjudication guidelines, policies, and references into edit policies
and rules.
Excellent verbal & written communication skills with project management experience
Proficient in Microsoft Office suite (Word, Excel, Power Point etc.)
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.