Job Description
Note: The job is a remote job and is open to candidates in USA. Molina Healthcare is a healthcare company that provides various services, and they are seeking an Associate Analyst for claims research activities. This role is responsible for the timely and accurate resolution of provider-submitted claims issues, requiring strong analytical skills and knowledge of medical claims processing. Responsibilities • Reviews and analyzes claims-related issues submitted by providers to identify potential root causes quickly and accurately. • Triages issues based on type and complexity, assigning them to the appropriate department or team for further research or correction. • Leverages knowledge of claims processing workflows, billing practices, and regulatory guidelines to provide accurate assessments. • Meets quality and production goals. • Maintains detailed records of claim reviews and resolutions. • Identifies trends in submitted issues to inform process improvements and reduce recurring errors. • Provides feedback and recommendations for process improvements. • Completes training and development activities to stay current with industry standards and best practices. Skills • At least 1 year of experience in claims processing or operations or equivalent combination of relevant education and experience • Basic knowledge of medical billing and basic claims processes. • Problem-solving skills • Verbal and written communication skills and ability to collaborate • Ability to work independently and as part of a team • Microsoft Office suite/applicable software program(s) proficiency • Experience with process improvement methodologies. • Knowledge of industry regulations and compliance standards. • Familiarity with systems used to manage claims inquiries and adjustment requests • Understanding of billing and coding procedures • Experience with Medicaid, Medicare, and Marketplace claims Benefits • Competitive benefits and compensation package Company Overview • Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals. It was founded in 1980, and is headquartered in Long Beach, California, USA, with a workforce of 10001+ employees. Its website is Apply tot his job