Claims Examiner Analyst Healthcare in Omaha, NE

Claims Examiner Analyst Healthcare Job Description

These professionals must have knowledge of standard claims coding and the ability to process all claim types, as well as experience with healthcare benefits structures and insurance procedures. Candidates should have strong writing and verbal skills and be proficient with Microsoft Office and familiar with HIPAA provisions. An associate’s degree or commensurate work experience is required.

Typical claims examiner analyst duties:

Reviewing and evaluating incoming claims for appropriate coding against the charges that are being billedDetermining the level of reimbursement based on established criteria, provider contract or plan provisionsDenying all claims ineligible for payment and entering coding informationIdentifying and reporting inaccuracies that are related to system configuration, benefit inconsistency and fee schedulesIdentifying circumstances that require claim payment, development or denial and producing the appropriate corresponding outcomes

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Salary for Claims Examiner Analyst Healthcare in Omaha, NE
45590 - 65475
25th percentile
45590
New to the role, with little or no experience; requires more than casual instruction or supervision to perform day-to-day duties
50th percentile
56018
Has the experience to consistently perform core responsibilities without direct supervision; very comfortable with processes and subject matter associated with the role
75th percentile
65475
Value to the organization goes far beyond the ability to perform normal job duties; has rare qualifications that enable consistent contribution in unique ways; ready for next career level when available
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