Job Description

One of our clients on the Southside area of Jacksonville, FL has an immediate need for a Clinical Support Analyst. The perfect candidate will have the following skills and experience:
  • Creating and sending denial letters to providers and members in accordance to NCQA requirements
  • Research, coordinate and resolve inquiries and claims exceptions
  • Coordinate with other Provider Service areas to identify formal education opportunities
  • Identify, document and monitor process improvements
  • Moderate to heavy keying required.
  • High School diploma or equivalent
  • 2+ years experience in health insurance, provider's office (handling medical coding, filing insurance claims or referrals) or a managed healthcare telephone service center
  • Experience working with healthcare products including researching and resolving provider inquiries and working with provider contracts and networks
  • Experience working with medical terminology, CPT-4 coding, ICD-9 coding and claims adjudication inquiry resolution processes and procedures
  • Experience working with MS Word and Excel
  • Experience with Legacy systems
  • Successful performance on job related assessments
  • Requires 9:45 a.m. to 6:15 p.m. shift coverage
If you believe that your skills and experience are a match for this position, please e-mail your resume to, or apply on line at (search jobs). 
If you have any questions, please call 904-998-9414 and reference Clinical Support position.

Application Instructions

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