Claims Research Analyst

Details

• Department: Patient Accounting
• Schedule: Full-Time, 8-hour day shift, Monday - Friday, Partially Remote
• Facility: Ascension Care Management Insurance
• Location: Austin, Texas

Benefits

Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community

 

*Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: PRN, Short-Term Option, etc.). Actual compensation offer will vary based upon role, education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics.

Responsibilities

As a Claims Research Analyst, you'll analyze claims information for risk management and insurance programs.

• Investigate claims and obtain relevant facts to determine coverage, loss and liability.
• Oversee legal and medical aspects of claim including oversight of law firms involved in the litigation of the claim.
• Resolve claim issues promptly and manage claim settlements within authority limits.
• Provide recommendation of claim and expense reserves.
• Strong knowledge of Texas Medicaid pricing. 

Requirements

Education:

• High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.

Additional Preferences

Additional preferences:

• 1 to 2 years of appeals experience, preferred.
• 1 to 2 years of Texas health plan operations experience, preferred.
• 1 to 2 years of strong claims auditing and investigation experience, preferred.
• 1 to 2 years of strong Claims Research experience, involving collecting relevant inforamation to design meaningful data to create a set conclusion to have claims reprocessed, preferred. 

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Why Join Our Team

Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters.

 

Ascension is a leading non-profit, faith-based national health system made up of over 150,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

 

Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.

Equal Employment Opportunity Employer

Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.

 

For further information, view the  EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

 

As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.

 

Pay Non-Discrimination Notice

 

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.

 

E-Verify Statement

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