Join our community
Community Health Networkhas an excellent Customer Service Analyst opportunity available within our Encore Payroll team. If you are looking for challenging work and meaningful advancement, consider a career with Community!

Where you fit in

The primary responsibility of the Customer Service Analyst is to assist providers, members and payers with information relating to benefits and member claims status. These responsibilities include claim adjudication for UB and HCFA claims in accordance to CMS guidelines. You will adjudicate claims received from Encore's network affiliates, hospitals, physicians, and non-participating providers. Additionally, you will assist in investigating and resolving claims issues from members, providers, and payors.

Your exceptional skills

• Utilize claim system to obtain and record claim information with ICD9 and CPT coding, reviewing to make claim payment decisions. Investigate and resolve claim inquires when Third Party Administrator request status of claim(s).
• Analyze and identify processing procedures for UB and HCFA claims submitted by providers according to CMS guidelines. Investigatemedical claims utilizing ICD-9, CPT-4 coding, HCPC and DRG coding methods to ensure provider reimbursements are accurate.
• Demonstrate claim adjudication knowledge by identifying potential systematic issues that result in claim(s) adjudicating incorrectly.Perform appropriate steps to manually adjudicate and reverse claim(s).
• Perform data entry and adjudicate UB and HCFA claims in an adjudicating claims system with knowledge of medical terminology andHIPAA regulations
• Report and identifies opportunities for process improvement to management

Your exceptional qualifications

• High School Diploma or GED (Required) Other College level courses leading towards a degree (Preferred)
• 3+ years: experience in healthcare, managed care, customer service and medical claim adjudication. (Required)

Your life with Community
You work hard to provide our patients with the exceptional care, and you deserve benefits to match. Community offers a unique employment package that encompasses not only your day-to-day job, but also your career.

You will have the opportunity to grow your career thanks to scholarships and tuition reimbursement from the Community Health Network Foundation and receive recognition for your achievements.

Apply today for immediate consideration.

A representative and diverse workforce

At Community Health Network, we build teams that deliver exceptional care through empathy, communication and collaboration. Caregivers play a vital role in our mission as they fulfill our PRIIDE values: Patients First. Relationships. Integrity. Inclusion. Diversity. Excellence.

Community is proud to be an equal opportunity employer, aiming to ensure that caregivers feel empowered, recognized and respected in our environment at all times. We value different perspectives by actively seeking a diverse workforce that is inclusive and equitable to all. For more information on how we work to advance diversity, equity and inclusion to provide culturally-competent care that meets your individual needs, visit eCommunity.com/diversity.

Apply Today!