Claims Analysis Sr Associate in Boston, Massachusetts For Sale

Title: Claims Analysis Sr Associate Location: MA-Quincy Job Responsibilities: The candidate will be responsible for auditing medical claims on a pre-payment basis in accordance with documented Claim Processing Guidelines, Contractual Terms, Plan Payment and Benefit Policies. They should be able to comprehend and apply provider contract language. This person is responsible to document audit results in a FOXPRO database for tracking and feedback purposes. The auditor is responsible to conduct a preliminary root cause analysis for errors found, identify systemic quality issues, and follow-up with internal departments as necessary. Auditors are responsible to attain and are measured against predetermined Quality and Productivity standards within the department as well as deadlines for completion of all audits and administrative tasks. Required Skills: 3 to 5 years experience with medical claim processing systems and/or procedures Familiarity with medical coding including CPT, HCPCS, ICD9, and DRG coding Understanding of electronic claim processes Demonstrated Analytic Ability Excellent written and oral communication skills Excellent organization skills Desired Skills: Hospital (UB04), Physician (CMSxxxx) Medical Claim Audit, Processing, or Billing Experience Familiarity with hospital contract language, methodologies and reimbursement policies Knowledge of industry standard code review editing software Prior Audit experience helpful Minimum Educational Requirements: High School Graduate Dell offers: -Opportunity to work with a strong brand at one of the world's largest IT solutions providers -Dynamic, challenging, international work environment -A team with a high level of energy, integrity and motivation to win -Exciting internal career opportunities -A commitment to diversity and inclusion -Competitive compensation including bonus plans & a great benefit package -An individual professional development plan About Dell Inc.: Want to work in an environment where each day is focused on delivering solutions that make a real difference in people's lives? Where teams are constantly curious, and different perspectives and experiences are valued? At Dell, we believe technology is essential for human success and that it should be accessible to everyone. We are constantly evolving to better serve our customers, seize new opportunities and drive growth. Together we can change the world. Come join us. For more information, visit us on the web athttp://www.dell.com/.