Provider Claims Process and Controls Analyst Jobs

The Provider Claims Process and Controls Analyst recommends a policy and process that ensure alignment with company guidelines and nationally accepted medical/coding standards. Researches and designs criteria to determine policy guidelines used in review of patient cases to ensure only medically appropriate services are reimbursed. Being a Provider Claims Process and Controls Analyst responds to questions from medical staff and communicates details about policy and guidelines. Establishes the proper codes to use for claims processing. In addition, Provider Claims Process and Controls Analyst r ... equires a bachelor's degree. Typically reports to a supervisor or manager. Requires Registered Nurse RN. Being a Provider Claims Process and Controls Analyst gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. Working as a Provider Claims Process and Controls Analyst typically requires 2 to 4 years of related experience. More
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