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ICONMA, LLC
Medicare Advantage (MA) Claims Analyst
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Job Description
Medicare Advantage (MA) Claims Analyst#26-35093
$33.83-$36.98 per hour
Detroit, MI
Hybrid
Job Description
Our Client, a Health Insurance company, is looking for a Medicare Advantage (MA) Claims Analyst for their Detroit, MI/Hybrid location.
Responsibilities:
This role is responsible for configuring MA benefit parameters in the claims platform to ensure compliance with CMS requirements, conducting detailed claim reviews to validate reimbursement accuracy, and identifying and resolving system defects in partnership with IT, NASCO, and vendor teams.
The ideal candidate will monitor regulatory and policy changes, analyze claims data to identify trends and root causes, develop solutions that improve payment accuracy and operational efficiency, and deliver meaningful reports and dashboards that provide stakeholders with insights into claim performance, defect resolution, and process improvement opportunities.
Requirements:
Strong analytical and problem-solving skills
Ability to complete medical claims analysis
Experience in system testing
Ability to quickly learn new system applications
Organizational skills and ability to prioritize; must be able to work on multiple tasks with varying timelines
Strong understanding of medical benefit application
Knowledge of CMS regulations
Bachelor's degree in related field is preferred
Benefits
- Health Insurance