Experienced Data Entry Analyst – Medical Claims Processing Expert

At arenaflex, we're revolutionizing the healthcare industry by providing a comprehensive health plan that prioritizes preventive care and offers more benefits. As a Data Entry Analyst with medical claims processing expertise, you'll play a vital role in helping us achieve our mission. If you're passionate about delivering exceptional results, building strong relationships, and making a meaningful impact in the healthcare sector, we want to hear from you.

About arenaflex

arenaflex is a forward-thinking company that's dedicated to transforming the healthcare landscape. Born out of the pandemic, we've created a health plan that's designed to meet the evolving needs of individuals, patients, and providers. Our innovative approach focuses on preventive care, affordability, and benefits that truly matter. As a Data Entry Analyst, you'll be part of a dynamic team that's passionate about making a difference in the lives of our members and the healthcare community.

Job Summary

We're seeking an experienced Data Entry Analyst with a strong background in medical claims processing to join our team. As a key member of our System Configuration Team, you'll be responsible for delivering day-to-day operations, ensuring timely claims processing, and collaborating with various departments to drive efficiency. If you're a detail-oriented, team-oriented individual with excellent communication skills and a passion for healthcare, we encourage you to apply.

Essential Duties and Functions

As a Data Entry Analyst with arenaflex, you'll be responsible for the following key tasks:

• Delivering day-to-day operations of the System Configuration Team activities
• Ensuring tasks for System Configuration teams are performed and completed, and communicated to other team members
• Collaborating with IT, Medical Services, Claims Team, System Support to ensure efficiency
• Reviewing PENDED claims on a daily basis for various reasons to ensure timely claims processing
• Working with the Claims Processing department to ensure day-to-day PENDS are handled in a timely manner
• Analyzing, tracking, and trending provider, system setup, and claim errors
• Working on claims team projects and reporting, assigned
• Assisting with all groups for professional and facility claim processing
• Attending departmental training when required or requested
• Adhering to the rules and regulations of arenaflex as described in the Employee Handbook and as defined in the unit/department/clinic procedures
• Performing other duties as assigned

Experience

To be successful in this role, you'll need:

• At least 3-5 years of experience in claims adjudication, including PPO and/or Medicaid, ERISA, Medicare, Level Funded, and Self-Funded experience with various claim payment systems in processing hospital, mental health, dental, and routine medical claims within given deadlines
• Excellent working knowledge of MS Access, Google Sheets, and Excel required
• Knowledge of medical terminology, ICD-10, CPT, and HCPCS coding
• Experience processing claims on the HealthEdge System is preferred
• Excellent computer and keyboarding skills, including familiarity with Windows
• Excellent interpersonal and problem-solving skills
• Excellent verbal and written communication skills to communicate clearly and effectively with all levels of staff, members, and providers
• Ability to be focused and sit for extended periods of time at a computer workstation
• Ability to work in a team environment and manage competing priorities
• Ability to calculate allowable amounts such as discounts, interest, and percentages

Knowledge, Skills, and Abilities

To excel in this role, you'll need:

• Ability to communicate with all levels of staff
• Advanced knowledge of claim coding and editing rules Optum/CMS
• Knowledge of TDI regulations and requirements for claims payments
• Knowledge of HIPPA regulations
• Knowledge of medical terminology, ICD-10 CPT, and HCPCS coding
• Proficient computer skills to include Microsoft Office applications and Google Sheets
• Excellent verbal and written communication skills
• Ability to communicate clearly and effectively
• Ability to sit for extended periods of time at a computer workstation
• Ability to multitask and think creatively
• Enrollment/Eligibility 834's knowledge
• Claims 837 Files knowledge
• Cobra Knowledge/COB Knowledge

Career Growth Opportunities and Learning Benefits

At arenaflex, we're committed to helping you grow and develop your skills. As a Data Entry Analyst, you'll have access to:

• Ongoing training and development opportunities to enhance your knowledge and skills
• Mentorship and coaching from experienced professionals
• Opportunities for career advancement and professional growth
• A dynamic and supportive work environment that encourages collaboration and innovation

Work Environment and Company Culture

arenaflex is a remote-friendly company that values flexibility and work-life balance. As a Data Entry Analyst, you'll have the opportunity to work from home and enjoy a comfortable and productive work environment. Our company culture is built on:

• Collaboration and teamwork
• Innovation and creativity
• Continuous learning and development
• Respect and inclusivity
• Open communication and transparency

Compensation, Perks, and Benefits

We offer a competitive compensation package that includes:

• A salary range of $60,000 - $80,000 per year, depending on experience
• Comprehensive health insurance, including medical, dental, and vision coverage
• 401(k) retirement plan with company match
• Paid time off and holidays
• Flexible work arrangements and remote work options
• Professional development opportunities and training

How to Apply

If you're a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity. Please submit your resume and cover letter to [insert contact information]. We can't wait to hear from you! Apply for this job