Healthcare Claims Data Analyst (Los Angeles candidates only)

Regal Medical Group•Los Angeles, CA

49d•$30

About The Position

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.

Requirements

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.
Excellent time management skills.
Outstanding communication skills.
Knowledge of Claim adjudication process (Professional & Institutional).
Fee schedule knowledge.

Nice To Haves

Knowledge and experience in Project Management preferred.
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.

Responsibilities

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.