Transcend Health Solutions, LLC MVA (Motor Vehicle Accident) Claims Analyst Remote · Full time Company website

Apply for MVA (Motor Vehicle Accident) Claims Analyst

Key Responsibilities:

• Review and process medical claims related to motor vehicle accidents for submission to third-party liability and first party carriers.

• Coordinate benefits with auto and health insurance plans, attorneys, and adjusters to ensure accurate billing and reimbursement.

• Verify auto insurance coverages and eligibility to determine appropriate payer responsibility.

• Investigate and resolve denials and underpayments through appeals, follow-up calls, and written correspondence.

• Interpret Explanation of Benefits (EOBs) and remittance advices to determine claim status and next steps.

• Communicate with healthcare providers, insurance companies, patients, and legal representatives to resolve claims efficiently.

• Ensure compliance with jurisdictional rules for submitting medical records and billing information.

• Maintain detailed documentation of claim activities for tracking and auditing purposes.

• Draft appeal letters and escalate complex issues to management as needed.

• Utilize medical terminology and coding accurately in claims processing.

• Demonstrate exceptional attendance and ability to work independently while meeting performance metrics.

• Uphold HIPAA guidelines and maintain confidentiality of sensitive information.

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Required Qualifications:

• In-depth knowledge of various auto insurance coverage types (PIP, MedPay, Bodily Injury, Liability).

• Familiarity with medical billing terminology and proficient in interpreting EOBs.

• Strong written communication skills for preparing effective appeals and correspondence.

• Detail-oriented, analytical, and self-motivated mindset.

• Excellent oral communication skills with a customer service-oriented approach.

• Proven track record of punctuality and attendance.

• Ability to multitask and prioritize tasks in a fast-paced, deadline-driven environment.

• High School Diploma required; Bachelor’s degree preferred or equivalent experience.

• Minimum of 2 years’ experience in medical billing or claims processing, preferably in MVA or liability claims.

• Proficiency in Microsoft Office and experience with EHR or billing software.

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Preferred Skills:

• Experience working with attorney liens or hospital lien statutes.

• Understanding of coordination of benefits (COB) and subrogation processes.

• Knowledge of state-specific MVA insurance regulations and claims procedures.

• Familiarity with hospital revenue cycle practices.