Experienced Data Entry Analyst – Medical Claims Processing Expert

At arenaflex, we're revolutionizing the way healthcare is delivered by creating a health plan that prioritizes preventive care and offers more benefits. As a Data Entry Analyst with medical claims processing expertise, you'll play a vital role in helping us achieve our mission. If you're passionate about making a difference in the lives of our members, patients, and providers, we want to hear from you.

About arenaflex

arenaflex is a forward-thinking company that's changing the face of healthcare. Born out of the pandemic, we've created a health plan that's built around a whole person's affordable preventive care. Our goal is to provide our members with accurate, consistent, and timely information, increasing satisfaction and retention. We're committed to building collaborative relationships with our members, patients, and providers, all while adhering to compliance guidelines.

Job Summary

As a Data Entry Analyst with medical claims processing expertise, you'll be responsible for delivering day-to-day operations of the arenaflex System Configuration Team activities. You'll work closely with IT, Medical Services, Claims Team, System Support, and other stakeholders to ensure efficiency and timely processing of claims. Your expertise in medical claims processing, including PPO and/or Medicaid, ERISA, Medicare, Level Funded, and Self-Funded, will be invaluable in helping us achieve our goals.

Essential Duties and Functions

* Successfully deliver the day-to-day operations of the arenaflex System Configuration Team activities.

• Consistently ensure tasks for System Configuration teams are performed and completed, and communicated to other team members.
• Work closely with IT, Medical Services, Claims Team, System Support, to ensure efficiency and timely processing of claims.
• Review PENDED claims on a daily basis for various reasons to ensure claims are processed timely.
• Work with the Claims Processing department to ensure day-to-day PENDS are handled in a timely manner.
• Analyze, track, and trend provider, system setup, and claim errors.
• Work on claims team projects and reporting, as assigned.
• Assist with all groups for professional and facility claim processing.
• Attend departmental training when required or requested.
• Adhere to the rules and regulations of arenaflex as described in the Employee Handbook and as defined in the unit/department/clinic procedures.
• Perform other duties as assigned.

Experience

* At least 3-5 years of experience in claims adjudication, including PPO and/or Medicaid, ERISA, Medicare, Level Funded, and Self-Funded.

• Excellent working knowledge of MS Access, Google Sheets, and Excel required.
• Knowledge of medical terminology, ICD-10, CPT, and HCPCS coding.
• Experience processing claims on the HealthEdge System is preferred.
• Excellent computer and keyboarding skills, including familiarity with Windows.
• Excellent interpersonal and problem-solving skills.
• Excellent verbal and written communication skills to communicate clearly and effectively with all levels of staff, members, and providers.
• Ability to be focused and sit for extended periods of time at a computer workstation.
• Ability to work in a team environment and manage competing priorities.
• Ability to calculate allowable amounts such as discounts, interest, and percentages.

Knowledge, Skills, and Abilities

* Ability to communicate with all levels of staff.

• Advanced knowledge of claim coding and editing rules Optum/CMS.
• Knowledge of TDI regulations and requirements for claims payments.
• Knowledge of HIPAA regulations.
• Knowledge of medical terminology, ICD-10, CPT, and HCPCS coding.
• Proficient computer skills to include Microsoft Office applications and Google Sheets.
• Excellent verbal and written communication skills.
• Ability to communicate clearly and effectively.
• Ability to sit for extended periods of time at a computer workstation.
• Performs other duties and projects assigned.
• Ability to multitask and think creatively.
• Enrollment/Eligibility 834's knowledge.
• Claims 837 Files knowledge.
• Cobra Knowledge/COB Knowledge.

Why Join arenaflex?

* Work in a dynamic and fast-paced environment with a team of passionate professionals.

• Enjoy a comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off.
• Participate in ongoing training and development opportunities to enhance your skills and knowledge.
• Collaborate with cross-functional teams to drive innovation and excellence in healthcare.
• Make a meaningful difference in the lives of our members, patients, and providers.

How to Apply

If you're a motivated and detail-oriented individual with a passion for medical claims processing, we encourage you to apply for this exciting opportunity. Please submit your resume and cover letter to [insert contact information]. We can't wait to hear from you!

Equal Employment Opportunity

arenaflex is an equal employment opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive and respectful work environment that values diversity, equity, and inclusion. Apply for this job