Medical Claims Analyst

Job Description:

Are you a high-performing collections analyst and underpaid? Join a team where compensation and opportunities have no limits!

We are seeking an experienced Medical Claims Analyst with extensive knowledge in the Federal ERISA appeals process to join our team. This role is critical in analyzing, processing, and resolving claims in accordance with the Employee Retirement Income Security Act (ERISA) guidelines. The ideal candidate will have a strong background in ERISA claims, a keen eye for detail, and excellent problem-solving skills.

We Offer:

• Flexible work schedule Monday-Friday
• FREE Meals
• PTO
• Full Benefits & 401K
• Bonus Structure
• Casual work attire environment

Responsibilities:

• Subject matter expert in ERISA-related claims.
• Current claims processing background with an in-depth understanding of hospital billing form requirements (UB-04)
• Knowledge of medical terminology, CPT codes, modifiers, and diagnosis codes
• Complete understanding of the revenue cycle process to include prior authorization, billing, insurance appeals, and hospital collections
• Review and process self-funded claims in compliance with ERISA regulations.
• Interpret and apply ERISA guidelines to determine claim eligibility and benefits.
• Conduct detailed investigations into claims, including document review and communication with claimants, plan sponsors, and administrators.
• Utilize legal knowledge to ensure adherence to all ERISA-related provisions and regulations.
• Provide expert advice and guidance on ERISA claims processing to team members and leadership.
• Maintain accurate and up-to-date records of claims and decisions.
• Stay informed of changes in ERISA regulations and industry best practices.
• Communicate effectively with Plan Administrators.
• Utilize a variety of EHR systems.
• Strong organizational skills and the ability to manage multiple cases efficiently.
• Excellent problem-solving abilities and a proactive approach to resolving issues.
• Ability to work independently and as part of a collaborative team

Qualifications:

• Minimum of 2 years of experience in ERISA claims analysis or a related role.
• In-depth knowledge of ERISA regulations and their application in claims processing.
• Excellent analytical and decision-making skills.
• Strong communication skills, both written and verbal.

Please note: Only applicants with vast knowledge of hospitals claims denials need apply.

ERISA Recovery believes in a work-life balance and offers a competitive compensation package including a flexible work schedule, 401k, bonus plan and medical and dental benefits.

ERISA Recovery is an Equal Opportunity Employer