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Senior Healthcare Claims Analyst Job in Baltimore, Maryland

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Job Title: Senior Healthcare Claims Analyst

Employer:PBMares, LLP
Type:Salaried
Skills:Auditing
Required Experience:3 to 4 years
Preferred Experience:5 to 7 years
Location:Baltimore, MD
Date Posted:1/31/2019

PBMares is a leading accounting and business consulting firm serving the Mid Atlantic, as well as specialty areas nationwide and internationally. With over 270 employees in Virginia and Maryland, we are a full-service accounting and advisory firm with a strong reputation for integrity and ethical leadership. We are also a firm that has experienced uninterrupted growth throughout our 50-year history. In 2018, we earned the honor of being named as one of the nation’s Top 100 accounting firms by INSIDE Public Accounting, the leading public accounting publication. With so much to offer professionals at all experience levels, PBMares is one firm you definitely want to get to know when you are ready to move forward in your career.

Become part of a high caliber team to assist in assessing the accuracy of healthcare and other benefit payments issued by national insurance carriers. As a Senior Healthcare Claims Analyst you will be responsible for performing comprehensive research to identify provider billing abnormalities and claim payment errors with the overall goal to ensure proper benefit administration for our clients.

This role will be based out of our Baltimore office located along the Inner Harbor.

Responsibilities:

  • Performs assigned audits in a professional manner and in accordance with the approved audit program
  • Evaluates the adequacy of internal controls and compliance with company policies and procedures by examining transactions, documents, records and reports, and observing procedures
  • Identifies and defines issues and reviews and analyzes evidence
  • Prepares working papers, which record and summarize data on the assigned audit segment, in accordance with professional standards
  • Assists in recommendations and writing reports documenting the results of the audit
  • Utilizes data for the purpose of verifying errors and identifying systemic errors
  • Works as an active team member during scheduled engagements and work collaboratively to achieve the goals of the team
  • Provides feedback to the team lead on any issues identified during research or claims review.

Requirements:

  • Bachelor’s Degree preferred
  • Minimum 3-5 years of experience with healthcare claims, billing, and/or coding directly for a hospital system, consulting firm, or major insurance company
  • A strong working knowledge and understanding of the healthcare industry
  • Strong communication skills, including the ability to build relationships and articulate thoughts clearly and effectively
  • Willing to travel 15 – 20 weeks per year
  • Proven experience using MS Office products

Our Firm’s policy is to provide equal opportunity for employment  to all individuals regardless of their race, color, religion, sex, national origin, age, genetic information, disability, veteran status, sexual orientation, gender identity, or any other characteristic protected by federal, state, or local laws. 

We are proud to be an EEO/AA employer M/F/D/V. We maintain a drug-free workplace and perform pre-employment substance abuse testing.

This contractor and subcontractor shall abide by the requirements of 41 CFR 60-741.5(a).  This regulation prohibits discrimination against qualified individuals on the basis of disability, and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified individuals with disabilities.

Must be authorized to work in the United States permanently without the requirements of sponsorship at any point in the future. 

Applying

Email your cover letter and resume to cwessel@pbmares.com

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