Claims Escalation Analyst position requirements:
Accurately evaluates each account in order to determine what is needed, what is left outstanding and what steps are necessary to resolve the account quickly.
Communicates effectively with the assigned payer and makes appropriate decisions to escalate and push claims with carriers, companies and other departments to resolve any outstanding issues delaying claims processing.
Evaluates transactions posted on an account to ensure all payments and adjustments are posted and are appropriate.
Accurately post transactions based on assigned duties ensuring that keying is correct for all payments, adjustments, ded & coins assignments.
Understands assigned payers allowable calculations in order to preview an account to determine if properly paid and identify when errors are made in payments.
High school graduate or GED.
At least one year of experience working in healthcare related field, preferred.
Adequate keyboard skills (40 words per minute typing rate).
Basic computer skills.
Strong organizational and communication skills, including ability to discuss medical issues.
Negotiation skills including assertiveness and being proactive.