Claims Account Analyst

Claims Account Analyst is responsible for evaluating claims to ensure they are accurate and processed in a timely manner. They review and assess the validity of claims based on the policy guidelines. They also follow precise procedures in managing high-volume claims according to department goals and deadline. Adjudicate and process claims based on appropriate client business rules, utilizing department software and resources, interact with internal and external customers in a positive and professional manner, follow precise procedures, prioritize, plan and manage claim volume based on department deadline goals, work independently while maintaining team cohesiveness, identify and effectively communicate system issues to ensure accurate and timely payment processing, review documents to ensure that all forms are accurate and complete.

Key Accountabilities

• Evaluate all claims for accuracy and completeness of documentation.
• Review, investigate and determ...