Think Beyond The Label Jobs

Description

We are seeking a detail-oriented and experienced Medical Claims Analyst for our local healthcare client in Oakland, CA. The incumbent will be responsible for investigating, reviewing, and managing health insurance claims to ensure accuracy, responsiveness, and adherence to federal and state regulations.

Responsibilities:

· Review and analyze medical insurance claims for accuracy.

· Process and approve claims using medical coding and other pertinent information.

· Detect any fraudulent, abusive, or wasteful activities in insurance claims.

· Communicate with healthcare providers, patients, or other insurance companies for additional information or clarification.

· Recommend policy changes and enhancements based on claims trends and patterns.

· Adhere to all company, federal and state insurance policies, procedures, and regulations.

· Compile reports that detail claims trends, variances, and performance.

Requirements

· Bachelor's or associate degree in healthcare administration, business, finance or related field.

· Previous experience in medical billing and insurance claims review is necessary.

· Knowledge of medical terminology, ICD and CPT coding.

· Proficiency in using healthcare billing software and Microsoft Office Suite.

· Exceptional analytical skills and ability to work with complex information.

· Strong verbal and written communication skills.

· Exceptional attention to detail and accuracy.

· Strong critical-thinking abilities to uncover any instances of fraud or abuse.

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more.

All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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