9 claims analyst jobs at 4 companies in Yucaipa, CA
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Data Analyst Sr, Finance - Encounter Data (Covered California)
Orange, California, United States
$84k-$135k/yrHybridFull Time
CalOptima Health: Provides public health insurance for Orange County residents.
5+ YOEBachelor's plus 5 years data analyst experience with SQL; 3 years Medi-Cal managed care or Medicare Advantage and Covered California experience required; experience reconciling encounter/claims data and working with DHCS/CMS.
SQL, Electronic Data Interchange (EDI), Microsoft Word, Microsoft Outlook, Microsoft Excel, Microsoft PowerPoint
Inland Empire Health Plan: Public health plan managing Medi-Cal, Medicare-Medicaid, and Covered California coverage for Riverside and San Bernardino County residents.
5+ YOERequires 5+ years in payment integrity, claims auditing, or medical coding; bachelor's degree in business or health administration; strong SQL, data analysis, coding, regulatory, and claims expertise.
Eisenhower Health: Provides comprehensive medical care and hospital services in California.
3+ YOEHigh school diploma required (associate preferred). 3+ years hospital/professional billing experience with emphasis on denied claims, appeals, managed care and Medicare/Medi-Cal; knowledge of CPT/HCPCS/ICD-10, CMS rules, payor contracts, and strong Microsoft Office skills.
Microsoft Word, Microsoft Excel, Microsoft Outlook, Microsoft PowerPoint, Epic
CalOptima Health: Provides public health insurance for Orange County residents.
5+ YOEBachelor's in business/finance/risk or equivalent plus 5+ years in corporate risk management or insurance broker experience; insurance program administration, claims handling, contract review, and Microsoft Office proficiency.
Microsoft Word, Microsoft Outlook, Microsoft Excel, Microsoft PowerPoint
Inland Empire Health Plan: Public health plan managing Medi-Cal, Medicare-Medicaid, and Covered California coverage for Riverside and San Bernardino County residents.
3+ YOERequires 3+ years in healthcare claims, billing, or auditing; bachelor's degree in healthcare, finance, or related field; SQL and Microsoft Office proficiency; coding and health insurance contract knowledge.
SQL, Microsoft Office Suite, Microsoft Excel, Microsoft Access, CPT, ICD-10, HCPCS, NDC, AI, DRG
Inland Empire Health Plan: Public health plan providing managed care to residents.
3+ YOERequires 3+ years in healthcare claims, billing, or auditing; bachelor's degree in healthcare, finance, or related field; SQL and Microsoft Office proficiency; coding, contract interpretation, analytics, and regulatory knowledge.
SQL, Microsoft Office Suite, Microsoft Excel, Microsoft Access, AI, CPT, ICD-10, HCPCS, NDC, DRG, CMS, DHCS, HEDIS, CAHPS, NCQA, CalPERS, 457(b)
Liberty Dental Plan: Administers dental benefit plans for government and commercial markets.
2+ YOEHigh school diploma/GED, 2+ years PPO/HMO claims processing experience, HSP and dental procedure knowledge, proficiency with Word/Excel/Access, strong analytical and communication skills.
Microsoft Word, Microsoft Excel, Microsoft Access, Crystal Report, HSP
Liberty Dental Plan: Dental benefits administrator for government and commercial health plans.
2+ YOEHigh school diploma/GED, minimum 2 years PPO/HMO claims processing or auditing, HSP systems and dental procedure knowledge, Microsoft Word/Excel/Access and Crystal Reports proficiency, advanced analytical and communication skills.
Microsoft Word, Microsoft Excel, Microsoft Access, Crystal Reports, HSP
Inland Empire Health Plan: Public health plan providing managed care to residents.
5+ YOERequires 5+ years in payment integrity, claims auditing, or medical coding; bachelor's degree in business or health administration; SQL and Excel proficiency; coding and healthcare regulations expertise.