RRT Analyst - Product

Job description

Job DetailsJob Location: Allied Benefit Systems - CHICAGO, IL 60606Position Type: Full TimeSalary Range: $50,000.00 - $55,000.00 SalaryJob Category: Medical Management POSITION SUMMARY The RRT (Rapid Response Team) Analyst is responsible for reviewing, analyzing, and adjusting medical claims to ensure accurate processing in accordance with regulatory requirements, payer policies, and internal guidelines. This role involves investigating claim discrepancies, validating benefit coverage, correcting errors, and communicating with providers, members, and internal teams to resolve issues promptly and efficiently. ESSENTIAL FUNCTIONS: Review medical claims flagged for adjustment, correction, or reconsideration. Verify claim accuracy, including coding (ICD 10, CPT, HCPCS), billed charges, and reimbursement methodologies. Research missing or conflicting information and resolve discrepancies in accordance with organizational and payer rules. Process claims adjustments, denials, and reopens while maintaining high accuracy standards. Analyze medical records, billing documents, and provider submissions to confirm the validity of claims. Identify patterns or recurring errors and escalate them f...