Wisconsin Licensed Claims Analyst

Job Summary

A company is looking for a Claims Analyst II to examine and process claims in accordance with established policies and procedures.

Key Responsibilities

• Adjudicate claims by following departmental policies and corporate guidelines
• Resolve claims and related issues while ensuring compliance with policy provisions
• Process payments for approved claims and maintain department quality standards

Required Qualifications

• High school diploma or equivalent preferred
• 2-4 years of claims processing experience required
• Knowledge of current procedural terminology (CPT) and international classification of diseases (ICD-9 and ICD-10)
• Prior experience with ACA, Medicaid, or similar health plans preferred
• Coding experience preferred