Claims Adjudication Analyst

Adecco is currently assisting a local client in their search to fill a Claims Analyst job in  Woonsocket, RI paying 13 / HR. Apply now if you meet the qualifications listed below!

Responsibilities for this Claims Analyst job include, but are not limited to:

  • Perform extensive testing and documentation to ensure accurate claims adjudication and compliance with pharmacy standards and payer specification sheets
  • Receiving third party program contract updates and creating or modifying third party plan configurations necessary to comply with industry standards, contract agreements and state and federal regulations
  • Working with Pharmacy Application Development teams in Information Systems (IS) to provide third party claims adjudication support for all system related issues or enhancements including defining business scenarios and testing procedures, analyzing production issues for any potential causes and recreating all known defects in test environments to assist development
  • Working cross functionally within the department to provide quality assurance for Performance, Contract Administration, Industry Relations and other departments by executing various scenarios affecting claims adjudication and provide detailed analysis of the results

Qualifications for this Claims Analyst job:

  • Must have High School Diploma or GED
  • Must have min 1 year of Microsoft Word and Excel use
  • Must have experience in a high volume environment ( call center or pharmacy technician etc.)

Additional Details:

Type:                      Fulltime (40 hours / week) contract

Length:                  4+ months with the possibility of a permanent offer

Pay:                        13 / HR

Shift/Hours:          8:30am – 5:00pm Monday - Friday

Why work for Adecco?

  • Weekly pay
  • 401(k) Plan
  • Skills Training
  • Excellent medical, dental, and vision benefits

IMPORTANT: This Claims Analyst job is being recruited for by Adecco’s National Recruitment Center, not your local Adecco Branch Office. To be considered for this position, you must use the “Apply with Adecco” button to submit your resume.

The Adecco Group is a global leader in HR services.  Our group connects over 700,000 associates with our business clients each day through our 6,600 offices in over 70 countries and territories around the world.  We offer employment opportunities at any stage in your professional career.  Contact us today to discuss available contract and direct hire positions.  Adecco Group provides one of the most comprehensive benefits packages in the industry to contract workers to include Holiday, 401(k), Insurance Benefit Plans

Equal Opportunity Employer Minorities/Women/Veterans/Disabled

Adecco will consider qualified applicants with arrest and conviction records for employment

  • Apply with Adecco

Reference number US_EN_99_022862_1190744