Job Description

The Certified Corrected Claim Resolution Analyst will be responsible for researching and auditing

medical records for complex, diverse, multi-specialty provider claims to identify and determine

appropriately coded billed services when compared to the Zelis Claim Edits Product. The Certified

Corrected Claim Resolution Analyst is responsible for processing, escalating, routing, and

responding to complex incoming Client and Provider corrected claims and inquiries.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com .

To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .

Skills and Requirements

3+ years of relevant experience or equivalent combination of education & work within healthcare

payer or provider.

Certified coder (CCS, CCS-P or CPC), or RN, LPN with coding certification is required.

Knowledge of healthcare reimbursement policies, state and federal regulations and applicable

industry standards.

Knowledge of correct coding and industry standard claim adjudication guidelines and policies.

Ability to translate coding and adjudication guidelines, policies, and references into edit policies

and rules.

Excellent verbal & written communication skills with project management experience

Proficient in Microsoft Office suite (Word, Excel, Power Point etc.) null

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion,sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to HR@insightglobal.com.