POSITION SUMMARY:
The RRT (Rapid Response Team) Analyst will be responsible for the handling of adjustments received from various departments timely. Examine claim calculations for adjustment and claimant's history to determine accuracy.

ESSENTIAL FUNCTIONS:
Handling of repricing adjustments.
Group exception referrals.
Work with other claim department personnel when necessary to determine appropriateness of RRT referral.
RX refunds and analysis.
Tracking and handling of projects.
Accumulator updates.
Recalculation of claims due to accumulator updates.
Other duties as assigned.

EDUCATION:
High School diploma or equivalent required

EXPERIENCE AND SKILLS:
Minimum of 3 years medical claims processing experience required.
Experience with the QicLink claims processing system preferred.
Applicant should be proficient in the use of the Excel and Word programs, have experience with or ability to learn Microsoft Access.
Ability to communicate effectively both orally and by email.

POSITION COMPETENCIES:
Job Knowledge
Time Management
Accountability
Communication
Initiative
Customer Focus

PHYSICAL DEMANDS:
This is a standard desk role - long periods of sitting and working on a computer are required.

WORK ENVIROMENT:
Remote

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.