Driscoll Children's Hospital · 1 day ago
Claims Processing Analyst II
Driscoll Children's Hospital is a compassionate organization that combines innovation and technology to support its employees. They are seeking a Claims Processing Analyst II to perform claims analysis and support claims administration, while also collaborating with internal partners to ensure accuracy and efficiency in claims processing.
Child CareChildrenHealth CareMedical
Responsibilities
Validate submitted claims data to ensure accuracy, validity, and integrity
Analyze pending claims and collaborate with internal business partners for necessary information and assistance, according to departmental procedures
Effectively prioritize and complete all assigned tasks within appropriate timeframes and with the required level of quality
Evaluate claims issues and procedures to identify and suggest opportunities for improvement, both in efficiency and quality
Openly participate in team meetings, providing ideas and suggestions to ensure departmental best practices, and to develop and promote teamwork
Maintain required compliance with privacy and confidential standards
Maintain or exceed all established standards for performance, quality, and timeliness
Support the Claims department in review, investigation, and research of claims issues and completion of claims projects
Communicate effectively, in verbal or written form, by sharing ideas and reporting facts and issues
Demonstrate business practices and personal actions that are ethical and adhere to all Health System and Health Plan policies and procedures
Assist with other related work responsibilities as requested
Qualification
Required
Minimum of five years' professional experience in claims analysis, provider medical billing, or medical coding
Proficiency with Microsoft Excel and Word, as well as with medical terminology coding and billing concepts
Advanced experience with health insurance and managed care principles
Experience with Complex claims analysis and resolution
Ability to work independently, or in a team environment, toward meeting common goals
Integrity and discretion to maintain confidentiality of member and provider data
Company
Driscoll Children's Hospital
We provide the absolute best pediatric care in South Texas, where care and community come together. Together, we heal.
Funding
Current Stage
Late StageTotal Funding
$0.53MKey Investors
Toyota Motor
2024-09-26Grant· $0.53M
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