Claims Analyst jobs in Tennessee

JOB TITLE:  Claims Data Analyst

SUMMARY:
Collects, analyzes, and interprets data to support strategic decision making and to make recommendations for revenue capture and process improvements. This position standardizes the
data-gathering process and organizes and optimizes the output. This position requires strong critical thinking skills and advanced Excel skills. The Claims Data Analyst acts as the subject matter in reimbursements. To thrive in this role, you should enjoy working with data and researching payment issues.

EDUCATION AND EXPERIENCE

Education: Bachelor’s degree in business, computer science or healthcare related field of study.
Licensure: N/A
Certification: N/A
Experience: Two to three years of recent relevant experience, preferably in a healthcare related
field.
Knowledge/Skills: Excel, Crystal Reports, and Claims Analysis skills
Revenue Cycle and Billing/Claims experience
Strong Verbal/written communication skills
Ability to solve problems using critical thinking skills
Ability to handle many projects at one time

EQUIPMENT:
Computer, fax, copier and any other equipment required to perform the functions of the position.

MAJOR DUTIES AND RESPONSIBILITIES:1. Performs analysis of claims, identifies trends, presents opportunity areas, and prioritizes
initiatives for reimbursement capture.

2. Establishes an ongoing working relationship with other departments impacting
reimbursement.

3. Leads meetings to present findings to Senior Leaders of revenue enhancement and process
improvement opportunities.

4. Develops and maintains databases and spreadsheets for data analysis and reporting to
management

5. Provides technical support and guidance to departments regarding data analysis and
interpretation.

6. Retrieves data for standard and ad hoc reporting to aid in performance measurement for the
organization.

7. Acts as liaison between Finance and IT department to help ensure systems are working as
intended.

8. Attends and participates in regularly scheduled staff meetings and in-services and individual
program planning staffings as needed.

9. All other duties as assigned.

PERFORMANCE RESPONSIBILITIES:

Although each position has its own unique duties and responsibilities, the following listing applies to every employee. All employees of the organization are expected to:

1. Support the organization’s mission, vision, and values of excellence and competence, collaboration, innovation, commitment to our community, and accountability and ownership.
2. Exercise necessary cost control measures.

3. Maintain positive internal and external customer service relationships.

4. Demonstrate effective communication skills by conveying necessary information accurately,
listening effectively and asking questions when clarification is needed.

5. Plan and organize work effectively and ensure its completion.

6. Demonstrate reliability by arriving to work on time and utilizing effective time management.

7. Meet all productivity requirements.

8. Demonstrate team behavior and must be willing to promote a team-oriented environment.

9. Represent the organization professionally at all times.

10. Demonstrate initiative and strive to continually improve processes and relationships.

11. Follows all Frontier Health rules, policies and procedures as well as any applicable laws and
standards.