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Baylor Scott & White Health

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Dallas, Texas

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Durham, North Carolina

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New York, New York

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Durham, North Carolina

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Children's Minnesota

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Claims Analyst - Hybrid Dallas
JOB SUMMARYThis hybrid role as the Claims Analyst is accountable for claims processing, research, and adjudication to correctly apply benefit determination and pricing for areas of responsibility to include clinic professional claims, physician claims, and Rx-drug claims (CMS 1500 and UB04), by claims processing guidelines.ESSENTIAL FUNCTIONS OF THE ROLEProcesses and adjusts professional and facility claims, including, but not limited to, transplant, special handle, negotiations, and MSO, according to claims processing guidelines. Maintains confidentiality rules in compliance with HIPPA guidelines.Pends claims as directed by departmental policies and procedures; follows up for resolution; and processes pended claims imme


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