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Claims Analyst II
Network Health’s success is rooted in its mission to create healthy and strong Wisconsin communities. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking a Claims Analyst II who will examine and process paper claims and/or electronic claims. The person in this role determines whether to return, pend, deny or pay claims within established policies and procedures. Determines steps necessary for adjudication. Follows established departmental policies and procedures, operating memos and corporate policies to resolve claim and claim issues. Settles claims with Claimants in accordance with policy provisions. Compares claims application and/or provider statement with policy file and other records to evaluate completeness and validity of claim. Pays claimant’s amount due.
Additional detail can be found on our careers site: https://recruiting.ultipro.com/NET1004/JobBoard/4854471e-f2ab-4bed-a3cd-3f7a1072bfef/OpportunityDetail?opportunityId=4191dfdb-7e43-4096-885e-6b4a1ace00ba
Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model.
Network Health is an Affirmative Action & Equal Opportunity Employer. We encourage applications from all backgrounds, communities and industries, and are committed to having a team that is made up of diverse skills, experiences and abilities. We are committed to equality and diversity within Network Health.
Network Health is a DiversityJobs Employer Member for our commitment to diversity in the workplace.
*WARNING: Please beware of phishing scams that promote work-at-home opportunities and which may also pose as legitimate companies. Please be advised that Network Health recruiter will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for a role with our company. All of our positions require that you first complete an online application.
Time: Full time
Updated: 6/9/2022 3:38:53 PM