Health Care Claims Analyst

Immediate and strategic need for a Health Insurance Claims Analyst OR Claims Adjuster professional to join our client's team responsible for testing their end-to-end claims processing and adjudication system. The Claims Analyst and/or Adjuster professional will be responsible for loading test claims data with multiple transaction types and based on real life scenarios. The Analyst will engage closely with claims application testers and developers to proactively correct issues before they disrupt production or cause miss payments to providers. The Analyst along with their team will help the organization reduce defects, reduce manual rework and drive down costs.

Required Skills

The ideal candidate will demonstrate the following background, experience and know-how
* 5 plus years of Health Insurance benefits
* 5 plus years of Health Insurance Claims processing experience
* Understanding and knowledge of
- Claims adjudication
- Testing and validating claims data
- Coordination of benefits
- Medicare & Medicaid Services (CMS) is a PLUS
- TriZetto healthcare products is a PLUS
- TriZetto QNXT is a PLUS
- McKesson ClaimCheck is a PLUS

Must have professional attributes that include:
* Analytical and inquisitive
* Solid documentation / reporting skills
* Ability to communicate effectively

**About the Client**
Mid-sized stable organization with employee longevity and stability. They are part of a National Union with this group responsible for a National Health Plan provided to their Union Membership. The organization is a preferred provider organization (PPO) committed to innovation in the Health Plan space. Our client offers a competitive salary and benefits package that includes a Pension. In addition to a competitive full time salary, our client offers comprehensive benefits including; PTOs, 11 holidays, tuition, pension, 401K, LTD, life insurance, health/dental and vision insurance.

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Glen Burnie, MD



Anticipated Start Date

Monday, August 27, 2018

Job Type

Direct Hire

Anticipated Duration

Direct Placement

Date Posted

Tuesday, August 7, 2018

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Elite Technical Services, Inc. participates in the E-Verify program to confirm the employment eligibility of all persons hired. This means that we will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS), with information from each new employee's Form I-9 to confirm work authorization. Elite Technical Services, Inc. will not use E-Verify to pre-screen job applicants.

Elite Technical Services, Inc. is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.