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Claims Examiner Analyst Healthcare in Ventura, CA

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 Ventura, CA
59690 - 85725
25th percentile
59690
The candidate is new to the role and building the needed skills, experience and autonomy.
50th percentile
73343
The candidate has the experience to perform core responsibilities without direct supervision and is comfortable with the role’s processes and subject matter.
75th percentile
85725
The candidate delivers value beyond the stated job duties, has advanced qualifications and experience, and is ready for the next career level.
Projected salaries for related positions Position title 25th percentile 50th percentile 75th percentile Revenue Cycle Director – Healthcare 107315 139383 165418 Medical Collections Manager/Supervisor 78105 95568 111125 Medical Collections Specialist 46038 52070 61278 Medical Billing Manager/Supervisor 76200 94298 106680 Medical Biller 47625 53023 61595 Revenue Cycle Analyst – Healthcare 63500 81280 92710 Denials Specialist – Healthcare 47308 54610 63818 Payment Poster – Healthcare 46673 53023 58738 Charge Entry Clerk – Healthcare 46355 51435 57785 Claims Processor – Healthcare 46038 51435 59373

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