Molina Healthcare
Analyst, Claims Research (Remote)
6 days agoWhat's your preference?
Job Description
- Req#: 2035288
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Competitive salary and benefits package
- Opportunity for career advancement and growth within the organization
- Engaging work environment with a focus on collaboration
- Chance to improve claims processing efficiency and overall performance
- Work with a diverse range of claims across multiple states and programs
- Contribute to meaningful projects that impact providers and members
What to Expect (Job Responsibilities):
- Serve as a subject matter expert in claims, conducting research and analysis to resolve high-priority inquiries and projects
- Present in-depth analysis of claims research findings to leadership and operations teams
- Manage and lead complex claims projects initiated internally or through provider complaints
- Identify and remediate claims processing issues to reduce rework
- Collaborate with stakeholders to define claims requirements and recommend updates to standard operating procedures
What is Required (Qualifications):
- At least 3 years of medical claims processing experience, or equivalent combination of education and experience
- Experience with claims processing across multiple states, markets, and claim types
- Knowledge of claims processing for inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace programs
- Strong data research and analysis skills
- Proficiency in Microsoft Office suite, including Excel
How to Stand Out (Preferred Qualifications):
- Experience with healthcare claims analysis
- Project management experience
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Molina Healthcare is a managed care company headquartered in Long Beach, California, United States.
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