Benefits Analyst

TEKsystems • Los Angeles, CA

1d • $28 - $28 • Onsite

About The Position

The Benefits Analyst is responsible for supporting the daily operations, configuration, and maintenance of the medical group’s claims processing systems. This role ensures the accuracy of member benefit setups, eligibility data, claims adjudication, and overall financial integrity. The analyst applies strong analytical and technical skills to enhance system automation, improve data accuracy, and support efficient claims processing.

Requirements

• Claims system configuration and adjudication experience
• Strong knowledge of EZ-Cap
• Experience with fee schedule management
• Understanding of managed care contracts and DOFR (Division of Financial Responsibility)
• Proficiency in data integrity auditing and analysis
• Experience with benefits enrollment and eligibility verification
• Technical skills in SQL, Microsoft Access, and Excel
• Familiarity with ICD-9 and ICD-10 coding

Nice To Haves

• Claims System Configuration
• Claims Adjudication
• EZ-Cap System Expertise
• Fee Schedule Management
• Data Integrity & Auditing
• Managed Care Contract Interpretation
• Delegation (DOFR)
• Benefits & Eligibility Management
• Payment Integrity Analysis
• Database & Reporting Tools (SQL, Access)

Responsibilities

• Maintain and support claims processing systems, including configuration and ongoing system updates
• Ensure accurate setup and maintenance of member benefits, eligibility, and provider assignments
• Support claims adjudication processes to ensure timely and accurate reimbursement outcomes
• Interpret managed care contracts and translate requirements into system configurations and fee schedules
• Monitor and ensure data integrity across claims, benefits, and financial systems
• Conduct system testing and validation to support enhancements and process improvements
• Collaborate cross-functionally with operations, IT, and finance teams to resolve issues and optimize workflows
• Analyze data to identify trends, discrepancies, and opportunities for automation and efficiency improvements
• Support payment integrity initiatives and financial accuracy of claims processing

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

What This Job Offers

• Career Level: Mid Level
• Education Level: No Education Listed