Clinical Analyst
Summary
Reviews healthcare claims, resolves provider disputes, and builds dashboards to track billing errors and denials.
Clinical Analyst Investigate and resolve provider inquiries, including dismissals (e.g., incorrect CPT codes, ineligible beneficiary) and no-response cases. Prepare dashboards, audit summaries, SOP updates, and RCA documentation. Identify gaps, errors, and improvement opportunities across billing, coding, pends, denials, and utilization review. Collaborate with operations, coding, QA, and client teams to ensure accurate and timely case resolution. Ensure availability during business hours: 8:00…