The Requirements

To meet the basic qualification for this role, you will have legal authorization to work permanently in the United States for any employer without requiring a visa transfer or visa sponsorship. In addition, to be a good fit for the Medical Claims Analyst opportunity, you will have:

• A Bachelor's degree is preferred; Medical coding certification is a plus. Quick question for you - click here
• 2+ years of administrative experience; healthcare, hospital, insurance, medical terminology, coding and UB-04 claims forms experience preferred. 
• Strong customer service background preferred.
• Strong written and verbal communication skills with a laser focus to details.
• Self-motivation, a goal orientation, tenacity and a sense of urgency.
• The ability to flex your flexibility "muscle" and manage multiple priorities in a fast-paced environment.
• Ability to apply reasoning, logic and critical thinking to solve unfamiliar problems with little direction.
• Strong computer skills, including Intermediate proficiency in Excel, Word and data entry. 

The Role

Reporting to the Production Manager and MCA Supervisor, you'll join a team of 20-25 Analysts. As Medical Claims Analyst I, you're responsible for the intake processing and triage of all initial claim documents. This includes but is not limited to referral processing, obtaining required documents, medical records sorting and processing, to prepare for forensic review. Quick question for you - click here
 
Specifically, when our clients (insurance companies) make referrals, you'll review all the documents and UB-04 claims with an eagle eye, validate the patient and triage the documents into an Excel sheet. Once you have a valid referral and triage form, you'll implement a pay calculation to lower costs for the client. And finally you'll assemble and publish the Forensic Review Reports within time and quality assurance standards for the clients. At a high level, you'll be spending 80% of your time processing and triaging documents and the remaining 20% publishing provider packets.
 
You'll go through training for three weeks and we expect you to be up and running in a month. One of our KPIs for success is to ensure 97% quality assurance, three months in a row, and you will be tested and reviewed on this standard after completing 90-days.
 

What's In It for You

"Healthcare's Hottest" Poised for Explosive Growth: Equian has grown to become one of the nation's leading companies for healthcare reimbursement analysis and payment integrity. We have been voted one of 40 "Healthcare's Hottest" by Modern Healthcare and have been recognized by Inc. 5000 as one of the fastest growing companies in the United States. We are growing rapidly, both organically and through mergers and acquisitions, so depending on your ambition and aptitude, you can advance to MCA II. If you're coming from a healthcare environment you'll get a vantage view of the other side of the business and how insurance companies operate and/or you may explore other opportunities that will shape your career trajectory.
 
A Culture of Continuous Improvement: Equian offers a fun, fast paced, flexible environment with an eye on continuous improvement and rewards curious, innovative thinkers who are constantly pushing the envelope to improve our processes, taking an already epic product to its next level. And our results-driven, team-oriented environment will offer motivation and the high level support to bring your innovative ideas to life.
 
Recession Proof Leadership: Not only are you securing a position within the recession proof healthcare industry but our CIO Rick Fitzgerald is promoting a spirit of innovation. "We have a unique opportunity to help our customers realize more value from all of the exciting advances in big data, robotics, and machine learning," says Fitzgerald. "I look forward to identifying opportunities with the internal team of experts and customers that will drive our technology agenda forward."

Competitive compensation: In addition to a competitive wage, we offer a comprehensive benefits package that includes all you would expect plus some pleasant surprises, such as flexible spending accounts, tuition assistance, onsite gym and more. 
 

Keys to Success

Your medical background and ability to stay fluid with our ever changing priorities, multi-tasking and easily "switching gears" at a moment's notice is pivotal to your success. Laser focus attention to detail to triage documents and sleuthing skills to detect over-payments will differentiate a star performer from a mediocre one in our dynamic environment. We have a very unique process and will look to you to quickly scale the learning curve and thrive in our fast paced environment. And last but not least, you will bring a growth vs. a fixed mindset, remaining open to learning new technologies, processes and skills.
 

About Us

Equian is a leading provider of technology-enabled, data-driven solutions ensuring payment integrity across the healthcare, workers compensation and property & casualty industries. 

One of our nation's most pressing challenges is the rising cost and affordability of healthcare. At Equian, our efforts are dedicated to addressing this challenge. We provide solutions that ensure each healthcare interaction is paid accurately and at the lowest possible cost. We have a proven system to reduce healthcare cost through proprietary data analytics coupled with deep domain expertise. Once we have aligned with you and analyzed all of the data, we provide integrated payment integrity solutions that eliminate unnecessary spending.

With more than 1400 talented professionals working across the country, our people have transformed Equian into the thriving organization it has become today. Our team includes market experts for each industry we serve, so you can be sure we are ready to hit the ground running for you. Equian's team is dedicated to building lasting partnerships with clients. It is simply what we do best

Equian is backed by New Mountain Capital, a leading healthcare investment firm, and is recognized nationally by Inc. Magazine and Modern Healthcare as a leading high-growth company in health care.

Video: Equian team members share their thoughts around why the company is enjoying ongoing strong growth.