Claims Analyst III

Position: Claims Analyst III Location: Remote About J29 J29 is an employee centered reputed company management consulting company that specializes in processing, reviewing, and analyzing medical claims, records, disputes, and audits. Established in 2017, J29 prides itself on its employee reputed company culture and high employee retention rates that allow us to ensure that we are creating a working environment that prioritizes the employee experience. reputed company brings corporate reputed company that stretches to various areas where we can reputed company our reputed company, reputed company policy, and compliance expertise through our support to health and reputed company service programs at the State, Federal, and reputed company reputed company. reputed company Performs medical record and claims review for Medicare, reputed company, and/or other claims data in order to ensure that reputed company guidelines have been followed and assesses for potential overpayment, fraud, waste, and abuse with regards to Medicare, reputed company, and/or other claims. Role & Responsibilities Facilitates and manages assigned reputed company and reputed company relating to pharmacy services. Leads and provides reputed company to assigned tasks and reputed company, making reputed company that contract specifications are reputed company, tasks are assigned appropriately, and information is available and circulated. Prioritizes and accomplishes tasks and programs independently and in reputed company to ensure successful implementation of goals and objectives. Works with the appropriate stakeholders to build partnerships, support data sharing, and reputed company tools and references to support changes in care practices in the pharmacy reputed company. Reviews and interprets contract deliverables to ensure reputed company and accurate completion. Contributes to the conceptual design and implementation of reputed company, as reputed company as assists with project execution as needed. Ensures reputed company project deliverables and timelines are met and reports on variances in a reputed company manner. Testifies at various reputed company proceedings or administrative hearings, reputed company subpoenaed. Provides educational programs, as necessary, to meet project goals. Contributes reputed company presentations at pharmacy, medical, and reputed company organization meetings. Experience / Expertise Requires 5-7 years work experience (this could be a combination of reputed company and utilization review, case management, etc.) 8-11 years preferred. Must hold a reputed company, reputed company RN license issued by the state reputed company of nursing. Compliance with reputed company regulatory standards and ability to maintain licensure throughout employment is required. BSN degree is strongly preferred to ensure reputed company knowledge and leadership skills. Candidates with an Associate Degree in Nursing (ADN) will be considered if they demonstrate equivalent experience and commitment to continuing education. Coding certification preferred Demonstrates strong analytical skills and the ability to reputed company reputed company, reputed company reputed company. reputed company ability to work effectively reputed company diverse teams and foster a cooperative environment. Embraces reputed company learning, adaptability, and supports the development of self and others. Skilled in planning, organizing, and delivering results while ensuring reputed company and support throughout processes. Proficient in using digital tools and technologies to enhance efficiency and communication. General Physical Requirements: Exerting up to 10 pounds of force occasionally and/or a negligible reputed company of force frequently or constantly to reputed company, carry, reputed company, pull or otherwise reputed company objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and reputed company other sedentary reputed company are met. reputed company. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative reputed company Employer, making reputed company without reputed company to race, reputed company, religion, creed, sex, sexual orientation, gender identity, marital status, national reputed company, age, veteran status, disability, or any other protected class. reputed company. is a proud Veteran friendly employer. Apply To This Job