Description

Analytical and data-driven healthcare professional with progressive experience in claims operations, managed care contracting, and system configuration. Extensive expertise in ICD-10 and ICD-9 coding, with a strong ability to interpret contract language and translate it into accurate reimbursement outcomes while maintaining data integrity across complex payer systems. Proven success in implementing benefit configuration. Experienced in EZ-Cap, claims adjudication, and cross-functional systems testing to support accurate and timely payment processing. The Benefits Analyst is responsible of Providing daily leadership and coordination in the maintenance of Medical Group’s claims processing system. Supports accuracy of member benefit set up, assignments, claims processing, financial accuracy and data integrity. Applying analytical skills in improving system automation

Skills

ez cap, fee schedule, data integrity, managed care, Delegation, dofr, benefits ...