Senior Claims Operations Analyst – Encounters

This is a fully remote position, open to applicants in California.

📋 Description

• Act as the technical expert in Encounter Operations.

• Oversee encounter production, including submission, acceptance, rejection, timeliness, and data quality.

• Conduct root cause analysis for issues related to encounter processing.

• Work collaboratively with claims operations, IT teams, vendors, and regulatory bodies.

• Create detailed analyses, executive summaries, and reports.

⛳️ Requirements

• Must be a High School Graduate or possess a GED.

• A minimum of 5 years of experience in encounter operations or a related area.

• Familiarity with Medi-Cal, Medicare, D-SNP programs, and managed care operations.

• Experience in healthcare claims processing, as well as medical billing and coding methodologies.

• Proficient technical skills in MS Office applications, especially advanced Excel.

🏝️ Benefits

• Health insurance coverage.

• 401(k) matching program.

• Flexible working hours.

• Paid time off.

• Opportunities for professional development.