Talent.com
Healthcare Claims Data Analyst (Los Angeles candidates only)

Healthcare Claims Data Analyst (Los Angeles candidates only)

Regal Medical GroupNorthridge, CA, United States
13 hours ago
Job type
  • Full-time
Job description

Position Summary :

The Benefits Analyst is responsible of Providing daily leadership and coordination in the maintenance of Regal Medical Group's claims processing system. Supports accuracy of member benefit set up, assignments, claims processing, financial accuracy and data integrity. Applying analytical skills in improving system automation.

Essential Duties and Responsibilities include the following :

  • Provides daily oversight of benefits configuration, research and audit.
  • Develops and Implements data integrity initiatives for all supporting system configuration including fee schedules, provider contracts, benefits, eligibility and any other areas that support the effective operation of internal systems.
  • Coordinates with Data Management staff to provide standards be followed and performs random audits.
  • Communicates and implements programs within focused area of responsibility.
  • Communicates, monitors and audits processes and procedures necessary to achieve strategic objectives.
  • Ensure all systems within their area of responsibility are reliable, responsive and support to the needs of the Regal Medical Group network.
  • Develops and fosters a customer satisfaction focused, service mentality within department to strengthen and build relationships with Heritage Provider Network and other Regal Medical Group regions and departments and communicates a balanced view of Data Management importance in relation to other departments and business functions.
  • Supports initiatives that are identified, communicates and negotiates projects with the users and management.
  • Achieves successful delivery of data management deliverables meeting internal and external client needs.
  • Serves as an alternate client liaison for data management benefits issues.
  • Administers and ensures timely completion of all projects.
  • Reviews data management plans for content and structure.
  • Performs other duties as necessary.

The pay range for this position at commencement of employment is expected to be $30 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.

The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and / or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.

Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

If hired, employee will be in an "at-will position" and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department / team performance, and market factors.

As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

Full Time Position Benefits :

The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.

Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.

Health and Wellness :

  • Employer-paid comprehensive medical, pharmacy, and dental for employees
  • Vision insurance
  • Zero co-payments for employed physician office visits
  • Flexible Spending Account (FSA)
  • Employer-Paid Life Insurance
  • Employee Assistance Program (EAP)
  • Behavioral Health Services
  • Savings and Retirement :

  • 401k Retirement Savings Plan
  • Income Protection Insurance
  • Other Benefits :

  • Vacation Time
  • Company celebrations
  • Employee Assistance Program
  • Employee Referral Bonus
  • Tuition Reimbursement
  • License Renewal CEU Cost Reimbursement Program
  • Business-casual working environment
  • Sick days
  • Paid holidays
  • Mileage
  • Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

    Education and / or Experience :

  • Proficiency in Word, Excel, Access, PowerPoint, M.S. Project, Outlook, EZCAP, REA, ClearIQ (TransUnion), PRNLINK, and Encoderpro.
  • Knowledge in SQL Server.
  • Typing / Data entry skills and accuracy.
  • Proficiency in running data queries and data analyzing.
  • Knowledge and experience in Project Management preferred.
  • Excellent time management skills.
  • Outstanding communication skills.
  • Knowledge of Claim adjudication process (Professional & Institutional).
  • Fee schedule knowledge.
  • Diagnosis and procedures codes knowledge preferred.
  • Understanding of the Health Care industry, benefits, and eligibility processes preferred.
  • Medical group or IPA operations and information systems management preferred.
  • Ability to be a problem solver.
  • A bachelor's degree from a four-college or appropriate industry experience and / or certification preferred.
  • Create a job alert for this search

    Healthcare Data Analyst • Northridge, CA, United States

    Related jobs
    • Promoted
    • New!
    Data Analyst - Community Health

    Data Analyst - Community Health

    ProvidencePacoima, CA, United States
    Full-time
    This person is responsible for oversight of data collection, tracking and management of assessments, program evaluation planning and implementation, monitoring and reporting of outcomes, coordinati...Show moreLast updated: 3 hours ago
    • Promoted
    Associate Claims Specialist - Workers Compensation - West Region

    Associate Claims Specialist - Workers Compensation - West Region

    Liberty Mutual InsuranceLos Angeles, California, United States
    Full-time
    Schedule : Full-Time Salary Range : USD $49000.Job Category : Claims Description Ready to grow your career in a role that makes a meaningful impact? Liberty Mutual is hiring Workers' Compensation Clai...Show moreLast updated: 6 days ago
    • Promoted
    Sr. Healthcare Programmer, Data Analyst

    Sr. Healthcare Programmer, Data Analyst

    Regal Medical GroupNorthridge, CA, United States
    Full-time
    The Senior Healthcare Programmer / Analyst is responsible for designing and executing SQL queries to extract and analyze healthcare data. Key responsibilities include developing and generating reports...Show moreLast updated: 30+ days ago
    • Promoted
    Remote Medical Director - California HealthNet

    Remote Medical Director - California HealthNet

    Centene CorporationTopanga, CA, US
    Remote
    Full-time +1
    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified, national organization offe...Show moreLast updated: 1 day ago
    • Promoted
    Senior Claims Analyst - Insurance - North Hollywood, CA

    Senior Claims Analyst - Insurance - North Hollywood, CA

    Insurance ReliefBurbank, CA, United States
    Full-time
    Senior Claims Analyst - Insurance - North Hollywood, CA.An expanding insurance brokerage, boasting over 25 years of industry leadership and consistent growth, is actively seeking a Senior Claims An...Show moreLast updated: 25 days ago
    • Promoted
    Sr. Technical Analyst - Health insurance Data

    Sr. Technical Analyst - Health insurance Data

    ShiftCode AnalyticsLos Angeles, CA, United States
    Full-time +2
    Technical Analyst - Health insurance Data.Permanent employee status after 3-4 months.LOCAL to CA, with extra preference given to those who live in Southern CA. Candidates MUST not require sponsorshi...Show moreLast updated: 1 day ago
    • Promoted
    Health Data Analyst (Remote)

    Health Data Analyst (Remote)

    Easy RecruiterLos Angeles, CA, United States
    Remote
    Full-time
    About the job Health Data Analyst (Remote).The Health Data Analyst provides information, analyses, and consultation to internal and external stakeholders. This position assesses the performance of p...Show moreLast updated: 30+ days ago
    • Promoted
    Remote Investment Analyst – AI Trainer ($50-$60 / hour)

    Remote Investment Analyst – AI Trainer ($50-$60 / hour)

    Data AnnotationCamarillo, California
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show moreLast updated: 20 days ago
    • Promoted
    Moms Ultimate Job : Earn Up to $95,000+ from Home as a Surrogate!

    Moms Ultimate Job : Earn Up to $95,000+ from Home as a Surrogate!

    Physician's SurrogacyFrazier Park, CA, US
    Full-time +2
    Surrogates Start at $75K$95K+ $1,200 Bonus + $11K Pre-Pregnancy Payout.Looking for a high-paying opportunity with real support and no upfront costs?. Become a Surrogate and earn up to $95,000+.Up t...Show moreLast updated: 6 days ago
    • Promoted
    • New!
    healthcare analyst role than a BA

    healthcare analyst role than a BA

    RIT SolutionsGlendale, CA, United States
    Full-time
    Must have Facets and 834 EDI experience.Essential functions include interpreting business needs and issues by gathering, eliciting, analyzing, documenting, and validating the business area's user a...Show moreLast updated: 13 hours ago
    • Promoted
    California Labor & Employment Attorney - REMOTE

    California Labor & Employment Attorney - REMOTE

    JobotThousand Oaks, CA, US
    Remote
    Full-time
    Work onsite in Thousand Oaks or remote from anywhere in the U.This Jobot Job is hosted by : Karyn Spies.Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume.Sa...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    healthcare analyst role than a BA

    healthcare analyst role than a BA

    RIT Solutions, Inc.Glendale, CA, United States
    Full-time
    Must have FACETS and 834 EDI experience.Interpret business needs and issues by gathering, eliciting, analyzing, documenting and validating the Business area's user and technical (functional / non-fun...Show moreLast updated: 13 hours ago
    • Promoted
    • New!
    Business Analyst With Workers Compensation Claims - Hybrid

    Business Analyst With Workers Compensation Claims - Hybrid

    The Dignify Solutions, LLCLos Angeles, CA, United States
    Full-time
    Business Analyst With Workers Compensation Claims - Hybrid.Charlotte, NC; Chicago, IL; Colorado Springs, CO; Conshohocken, PA. Dallas, TX; Fargo, ND; Garden City, NY; Houston, TX; Jacksonville, IL;...Show moreLast updated: 13 hours ago
    • Promoted
    • New!
    Senior Information Systems Analyst - Business Intelligence Specialization

    Senior Information Systems Analyst - Business Intelligence Specialization

    Los Angeles Regional Reentry PartnershipLos Angeles, CA, United States
    Full-time
    Senior Information Systems Analyst - Business Intelligence Specialization.The Data & Analytics Unit is responsible for managing, analyzing, and interpreting healthcare data to support decision-maki...Show moreLast updated: 13 hours ago
    • Promoted
    Clinical Social Worker

    Clinical Social Worker

    California Department of Corrections and RehabilitationFRAZIER PARK, California, US
    Full-time
    Position : Clinical Social Worker Increased Salaries are Just the Beginning… The past few years have seen dramatic shifts in the health care landscape. California Correctional Health Care Services (C...Show moreLast updated: 30+ days ago
    • Promoted
    Employed Gastroenterology Opportunity in Beautiful La Quinta, CA

    Employed Gastroenterology Opportunity in Beautiful La Quinta, CA

    Desert Care NetworkLa Quinta, US
    Full-time
    Why You Will Love This Opportunity : .Full-time, employed position with .Busy outpatient clinic with strong ancillary support. Board Certified / Board Eligible in Gastroenterology.Eligible for Ca...Show moreLast updated: 4 days ago
    • Promoted
    AR Claims & Deductions Analyst

    AR Claims & Deductions Analyst

    BrevilleTorrance, CA, US
    Full-time
    AR Claims & Deductions Analyst.Over the past 80+ years Breville has grown to become an iconic global brand, delivering kitchen products to over 70 countries around the globe.Breville enhances peopl...Show moreLast updated: 30+ days ago
    • Promoted
    Travel CVOR Tech - $1,549 to $1,731 per week in Northridge, CA

    Travel CVOR Tech - $1,549 to $1,731 per week in Northridge, CA

    AlliedTravelCareersNorthridge, CA, US
    Full-time
    AlliedTravelCareers is working with Prime Time Healthcare to find a qualified CVOR Tech in Northridge, California, 91343!. Now Hiring : Allied Healthcare CVOR - Northridge, CA.Contact us for Pay Info...Show moreLast updated: 30+ days ago