$33.29 - $40.44 hourly
NorthBay Health
Fairfield, CA
At NorthBay Health, the Claims Analyst II is responsible for independently completing all tasks in claims adjudication, including processing adjustments. The position is co-responsible for the operational functions for the organization’s capitated hospital and medical group business, processing all claims, oversees customer service issues, researching/resolving payment issues and addressing corrections in the system with the Claims Specialist.
PRIMARY JOB RESPONSIBILITIES
Generates Department reports that are utilized weekly by the Claims Specialist position to track timely payment of claims.
Oversees the production of encounter data analysis and processing.
Lead point of service intake for all claims issues.
Claims preparation for determination of payment. Addresses corrections in the claim system and in operational processes.
Oversees grievances and provider dispute resolutions in partnership with the Claims...