Driscoll Children's Hospital · 4 days ago
Claims Processing Analyst II
Corpus Christi, TX
Full-time
Onsite
Senior Level
5+ years expDriscoll Children's Hospital is dedicated to combining compassion with innovation and technology, creating a family-like environment for its employees. The Claims Processing Analyst II is responsible for performing claims analysis and supporting claims administration, ensuring accuracy and integrity in claims processing while collaborating with internal partners.
Child CareChildrenHealth CareMedical
Responsibilities
Claim review / analysis of moderate to advanced complexity
Complex provider contract pricing
High dollars claim review
Claim research
Claim issue resolution
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.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
$0.53MKey Investors
Toyota Motor
2024-09-26Grant· $0.53M
Leadership Team
Mary Peterson
Executive Vice President and COO
Recent News
GlobeNewswire News Room
2025-07-10
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2025-03-06
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