Healthcare Services Analyst 60k+ DOE WEEKLY PAY
TEKsystems | |
$20.00 - $25.00 / hr | |
life insurance, sick time, 401(k), retirement plan | |
United States, Hawaii, Honolulu | |
Jan 03, 2025 | |
*Description*
Serves as the entry level position for the Healthcare Service Analyst job family. Employees in this position will gain the necessary knowledge, skills and competencies to research and respond to issues related to claim processing, new/revised reimbursement policies, benefits, and contracts. Learn how to load and review new codes, update pend resolutions. This employee receives direction from the Manager and or unit coordinator(s) and will develop a working knowledge of business as well as medical, benefit, contracting, and reimbursement policies/edits. Learns to analyze and present large amounts of data clearly. *Research and respond to low complexity internal and external inquires. *Use a variety of resources including, but not limited to on-line information files and databases, peer guidance, interviews with internal departments including clinical consultants, other Blue Cross/Blue Shield Plans and vendors. *Learns to assess business impact of new benefits, changes in medical or reimbursement policies/guidelines and tactics assigned in strategic planning. *Learns to conduct cost/benefit analysis of claims processing. Extract and analyze data using SQL, MicroStrategy and/or other tools as available. *Develop documentation, including cost/benefit and business impact analysis and recommendations to implement and/or improve claims processing. *Update and create CES pend resolutions. *Drive implementation of changes through writing of Work Intake Form, participation in multi-department meetings, contribution and review of requirements, validation of test cases, and post-implementation monitoring. *Focus on low complexity project implementations and pend resolution updates. *With the guidance of the Healthcare service analyst II, learns how to load new codes, downloading, processing and importing new codes (CPT, HCPC, ICD-10, etc.). *Prepare and submit files for review and configuration implementation. *Review new codes in assigned categories, work with Medical Management and Configuration to ensure appropriate claims processing/editing based on new code review. *Learn how to support audits of implemented policies and completed projects. *Identify and investigate areas involving cost increases, uncontrolled payments and/or inequitable payments. *Identification and resolution of issues and trends as a result of researching and responding to implementation requests, problem reports, and inquiries. *Develop clear, concise documentation complex business scenarios. This documentation will be used to develop policy/project systems and workflow requirements. *Skills* claims processing, medical coding, customer service, microsoft office, medical terminology, cpt coding *Top Skills Details* claims processing,medical coding,customer service,microsoft office *Additional Skills & Qualifications* Minimum - *Bachelor's degree or equivalent combination of education and work experience. *One (1) year related work experience. Preferred - *Experience in a position related to healthcare, claims processing, or medical coding Professional skills/knowledge and/or Technical skills/knowledge: Minimum - *Effective verbal, written communication skills *Excellent organizational and analytical skills Preferred - *Working knowledge of medical terminology, anatomy, and health plan benefits *Understanding of HMSA's business practices, benefit plans, medical and payment policies *Understanding of coding used in HMSA's business (i.e., CPT-4, ICD10-CM, HCPCS) *Experience with QNXT and CES claims processing *Knowledge of CIRF, Aerial, Serena Business Mashups, MS SharePoint, Provider Resource Center, Documentum, claim processing and pend resolution workflows WEST: #prioritywest *Pay and Benefits* The pay range for this position is $20.00 - $25.00 Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan * Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) *Workplace Type* This is a hybrid position in Honolulu,HI. *Application Deadline* This position will be accepting applications until Jan 17, 2025. About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. |