Claims Analyst

06/30/2006

Triad Healthcare, Inc. is a national company that assists health plans and employers in the management of patients with pain. We have a proven track record of providing unique solutions for Group Healthcare, Personal Injury (PIP) and Workers’ Compensation (WC) that mitigate risks and optimize healthcare costs.  Our company uses best practices and proprietary software to link payers (carriers), providers (physicians) and patients (members) resulting in operational efficiencies, lower administrative costs and better results for all. 

Triad Healthcare is a growing healthcare company in need of full and part time Claims Analysts.  The objective of the Claims Analyst position is to provide complete, accurate, and timely adjudication of claims.  This position requires the ability to initiate the investigation process in order to analyze pertinent information pertaining to the claim while achieving all production and quality goals. 

Primary Responsibilities:

• Investigate, analyze and process claims using established procedures
• Must meet or exceed established performance metrics for productivity and accuracy
• Timely processing of claims in accordance with client requirements, member eligibility, plan benefits and applicable network fees
• Interact with other claims analysts and serve as a reference source for resolving claims issues
• Provide phone support on claim issues and in doing so, resolve caller’s issues
• Demonstrate competency with Triad’s systems
• Complete special projects as assigned within outlined time frames.  Projects to include, but not limited to, research, system enhancements, reconciliation of provider accounts and tasks associated with various reports
• Maintain confidentiality of both provider and member information

Qualifications:

• College degree or equivalent work experience required
• Familiarity with medical/allied specialty terminology
• Familiarity with group or medical insurance coverage
• Excellent verbal and written communication skills along with problem solving/analytical skills
• Ability to work in a team environment and independently
• Ability to multi-task in a decision sensitive environment
• Aptitude to learn new technology
• Proficient in Excel, Word, PowerPoint, Visio and Outlook

Triad offers excellent compensation and benefits plans that includes Medical, Dental, Vision, 401K and Tuition Assistance.

Triad Healthcare, Inc is an Equal Opportunity Employer.

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