SENIOR OPERATION ANALYST
SYNERGEN Health
Total years of experience :3 years, 3 Months
• maintenance of computers
• Review and analyze medical claims for accuracy, completeness, and compliance with coding and billing guidelines.
• Verify patient information, treatment details, and insurance policy coverage to ensure claim eligibility.
• Accurately assign ICD-10, CPT, and HCPCS codes to diagnoses and procedures.
• Collaborate with healthcare providers and insurance companies to gather additional information and resolve claim-related issues. - Process claims in the billing system, updating claim status and calculating payment amounts. - Maintain detailed documentation of claims, decisions, and communications.
• Successfully appeal denied claims by providing supporting documentation and following up on the appeals process.
• Conduct regular data analysis to identify trends, potential fraud, and opportunities for process improvements with suppliers
• coaching a junior Ice Hockey team (10 hours/week)
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