# Claims Analyst Manager

**Company:** [Genesis Orthopedics & Sports Medicine](http://jobs.workable.com/companies/5mPAGzTzKZGY4fxAz3Acoz.md)
**Location:** Remote
**Workplace:** remote
**Employment type:** Full-time

[Apply for this job](http://jobs.workable.com/view/c9cfe4d4-168a-4a24-8e1c-0eb7fd79fd1e)

## Description

### **Claims Analyst**

_Remote/Full-time_

_**Join Our Mission at Genesis Orthopedics & Sports Medicine!**_

At **Genesis Orthopedics & Sports Medicine**, we believe high-quality orthopedic care should be accessible to all—not just those who can afford it. After 17 years of conventional practice, we took a step back, challenged the status quo, and reimagined healthcare delivery. Over four years, through hundreds of hours of research, global case studies, and bold innovation, we developed a new model that maintains our reputation for exceptional care while making our services more ethical and affordable.

_**Key Responsibilities**_ 

-   **Operations & Oversight**

-   Review and validate all contractual adjustments and ensure accuracy in claim posting and payer compliance.
-   Download and allocate new accounts to analysts from multiple EPIC workqueues based on payer, aging, and priority.
-   Audit processed claims for accuracy, completeness, and timeliness before submission or follow-up.
-   Perform quality checks and ensure analysts follow correct claim handling procedures.
-   Conduct daily and weekly performance reviews, tracking productivity and accuracy metrics.  
    

-   **Team Management**

-   Lead and support a team of claims analysts, providing guidance, performance feedback, and escalation support.
-   Review and summarize EOD (End of Day) and EOW (End of Week) reports to evaluate team output and resolve discrepancies.
-   Manage task assignments, track turnaround times, and balance workloads across analysts.
-   Provide training and corrective coaching when errors or trends are identified.  
    

-   **Claims & Denial Management**

-   Oversee denial trending and root cause analysis for all orthopedic-related claims.
-   Identify and escalate systemic issues such as incorrect coding, missing documentation, or payer configuration errors.
-   Work closely with billing, coding, and authorization teams to resolve high-value or high-impact claims.
-   Ensure claims are submitted, followed up, and appealed in accordance with payer guidelines and timely filing limits.  
    

-   **Analytics & Reporting**

-   Prepare and distribute daily, weekly, and monthly reports on claim status, denial trends, and AR performance.
-   Monitor KPIs such as denial rate, claim turnaround time, and first-pass resolution rate.
-   Track performance metrics for the entire team and provide data-driven recommendations for improvement.  
    

-   **Compliance & Continuous Improvement**

-   Ensure all claim activities comply with HIPAA, payer rules, and internal SOPs.
-   Stay current with orthopedic coding changes, payer updates, and EPIC workflows.
-   Recommend and implement process improvements to enhance claim accuracy and reduce rework.
-   Participate in audits and provide supporting claim documentation when required.

## Requirements

_**Qualifications**_

-   3–5 years of experience in medical claims management or billing, with a strong focus on orthopedic claims.
-   Proven experience managing or leading a claims or AR team in a healthcare setting.
-   Hands-on experience with EPIC system is required.
-   Excellent understanding of CPT/HCPCS codes, modifiers, EOBs, ERAs, CARC/RARC codes, and payer-specific denial handling.
-   Advanced Excel skills (pivot tables, lookups, trend tracking).
-   Exceptional attention to detail and strong problem-solving abilities.
-   Excellent communication skills and ability to work cross-functionally with billing, coding, and management teams.

## Benefits

**Why Choose Genesis?**

**Supportive Team** – Be part of a compassionate and professional healthcare team that values collaboration.

**Competitive Compensation** – Enjoy a strong base salary with opportunities for performance-based bonuses.

**Meaningful Impact** – Help us revolutionize healthcare by making top-tier orthopedic care accessible to everyone.

**Apply today and be part of something truly transformative at Genesis Orthopedics & Sports Medicine.**