Title: Analyst, Senior Claims Research

　　Location: 4101 Percival Road Columbia SC 29229 United States (Onsite)

　　Duration: 3 Months

　　Rate: $21/hr on W2

　　Shift: Mon to Fri ; 8am to 4:30pm ( Need to be flexible )

　　We are looking for an Analyst, Senior Claims Research to join one of our Fortune 500 clients.

　　Education &Qualifications:

　　High School Diploma or equivalent

　　5 years of combined claims and provider service experience in a healthcare environment.

　　3 years of experience with claims systems (may be concurrent).

　　Required skills:

　　Researches and resolves escalated, complex, and high profile claims issues.

　　Serves as POC (point of contact) with various professional and facility/hospital providers in the research and resolution of all claims issues.

　　May assist with escalated issues to include, but not limited to provider enrollment, medical review, appeals and/or finance.

　　Completes research efficiently and accurately to ensure the departmental goals are achieved.

　　20% Researches and resolves high profile claims issues.

　　Ensures claims processing errors are corrected according to the appropriate provider reimbursement contract.

　　May also research and resolve high profile issues including, but not limited to provider enrollment, medical review, appeals and/or finance, which may be received via written or telephone correspondence.

　　20% Serves as Point of Contact for various providers (professional and facility) to resolve all claims payment errors.

　　Conducts weekly conference calls with assigned providers to ensure open communication pertaining to all current issues.

　　20% Communicates/educates providers on proper coding of claims, claims filing, pricing concerns, contract questions, benefit/system updates, etc.

　　20% Determines if claims payment errors are the result of system issues.

　　Troubleshoots, and/or coordinates the resolution/correction of the system processing error.

　　10% Verifies disbursement requests to ensure the request is valid and appropriately documented. Researches rejected, transition, and paid status claims for validity and escalate as appropriate. Uses the various systems of the department/company to complete research.

　　10% Monitors inventory reports to ensure claims are resolved accordingly.

　　Provides documentation as requested for audit purposes.

　　May provide written or telephone correspondence to resolve claims issues.

　　Interview process :

　　1 st Round: In person

　　We are looking for the candidate who are eligible to work with any employers without sponsorship .

　　If you’re interested, please click “Apply” button.

　　If you are not available or this job is not a good fit at present, please share the job details with your friends/colleagues and let me know if anyone is interested.

　　ManpowerGroup is committed to providing equal employment opportunities in a professional, high quality work environment. It is the policy of ManpowerGroup and all of its subsidiaries to recruit, train, promote, transfer, pay and take all employment actions without regard to an employee's race, color, national origin, ancestry, sex, sexual orientation, gender identity, genetic information, religion, age, disability, protected veteran status, or any other basis protected by applicable law.