Analyst, Claims (Remote)

REQUIRED QUALIFICATIONS

• 3 ~ 5 years of direct experience minimum in Healthcare Insurance, Claims Adjudication and EDI requirements.
• In-depth knowledge of Medicare/Medicaid claims processing and CMS regulations.
• Detailed knowledge of claims adjudication - medical coding; HIPPS, CPT and HCPCS codes.
• 1-3 years in revenue cycle management.
• In-depth knowledge of eligibility, authorization process, skilled home health care procedures, and COB practices.
• Detailed knowledge of multiple benefit plan designs including In/Out of Network designs for DSNP, MA HMO, POS, PPO etc.
• SKILLS AND ABILITIES
• Beginner level Microsoft Office skills (PowerPoint, Word, Outlook).
• Intermediate level Microsoft Excel skills.
• Analytical, research, problem solving, and decision-making skills.
• Ability to adjudicate 185+ claims a day.
• tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.