Posted in Admin - Clerical 30+ days ago.
Type: Full-Time
The Encounter Analyst I review and monitors adjudicated claims for file submission and upstream processing and communicates with provider agencies and internal departments regarding claims submission, denial management, and system updates. The position tracks trends and patterns to identify irregularities in the ACS system and works with claims analyst to communicate claims issues. The position has shared responsibility for ensuring contract service level agreements are met.
This position is full-time remote. The selected candidate must reside in North Carolina and be willing to travel onsite at the Home office (Morrisville, NC) for trainings at minimum of 2 weeks.
Responsibilities & Duties
Research and Resolve Encounter Denials
Ensure Service Level Agreement (SLA) Maintenance
Manage Encounter Denials and Recoupments
Process and Reconcile Claims
Provide Feedback on Process Improvement
Communicate and Collaborate with Internal and External Stakeholders
Minimum Requirements
Education & Experience
Graduation from high school or equivalent and (4) four years of experience processing healthcare claims
Experience with Medicaid and IPRS preferred
Knowledge, Skills, & Abilities
Salary Range
$19.73 - $25.16/hourly
Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.
An excellent fringe benefit package accompanies the salary, which includes:
See job description
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