Top 63 Claims analyst Jobs in Hayward Ca

Triage Analyst - Zero Balance (Fully Remote)
Aspirion —Alameda, CA
- $25 - $32 an hour
- Full-time
- Remote
- HIPAA
- Research
- Mid-level
Quick Apply
3d
Customer Operations Claims Analyst
Kinder's —Walnut Creek, CA
- $105,000 - $115,000 a year
- ERP systems
- Research
- Mid-level
- Health insurance
- 401(k)
Quick Apply
Fraud Detection Analyst, Senior
Blue Shield of California —Oakland, CA
- $90,860 - $136,290 a year
- Full-time
- Hybrid work
- Background check
- CPA
- 5 years
- Work from home
Staff Data Analyst
Assured —Palo Alto, CA
- $175,000 - $195,000 a year
- Full-time
- Remote
- Mid-level
- SQL
- AWS
- Health savings account
- Paid holidays
Overpayments and Collections Analyst I/II - Limited Term (Open)
County of San Mateo —Redwood City, CA
- $6,189.73 - $8,760.27 a month
- Writing skills
- English
- Research
- Dental insurance
- Retirement plan
5d
Risk Analyst
Google —Sunnyvale, CA
- $116,000 - $166,000 a year
- Full-time
- Google Workspace
- Mid-level
- Office
APeX Claims Analyst
University of California San Francisco —San Francisco, CA
- Computer science
- Computer Science
- 3 years
Senior Compliance Analyst - FT- Days - Corporate Compliance @ MV
El Camino Hospital —Mountain View, CA
- $49.87 - $74.81 an hour
- 8 hour shift
- Nursing
- Hospital
- HIPAA
Quick Apply
EPIC APPLICATION ANALYST - MSO
NORTH EAST MEDICAL SERVICES —Burlingame, CA
- $42.79 - $48.75 an hour
- Weekends as needed
- Microsoft Excel
- Microsoft Outlook
- Bachelor of Science
- Health insurance
- Dental insurance
Medical Informatics Analyst, Consultant
Blue Shield of California —Oakland, CA
- $123,090 - $184,800 a year
- Full-time
- Hybrid work
- Background check
- Pass drug screening
- Office
- Work from home
5d
RCM Analyst
Verse Medical —San Francisco, CA
- Full-time
- Hybrid work
- Mid-level
- SQL
- Continuous improvement
1d
Claims Analyst or (Senior) Claims & Patient Safety Specialist
MIEC —Oakland, CA
- $73,050 - $156,958 a year
- Full-time
- Remote
- Customer service
- 5 years
- Bachelor of Science
- Health insurance
- Dental insurance
Program Analyst (Public Records Specialist)
The State Bar of California —San Francisco, CA
- $92,960 - $123,943 a year
- Full-time
- Hybrid work
- Word processing
- Writing skills
- Mid-level
Quick Apply
Enterprise Risk management Analyst (7204U) Ethics, Risk & Compliance Service #85328
University of California Berkeley —Berkeley, CA
- $82,800 - $100,000 a year
- Full-time
- Customer service
- Writing skills
- Research
Pharmacy 340B Analyst - Pharmacy- 1.0 FT - 8hrs days variable
Washington Hospital —Fremont, CA
- $84,000 - $122,000 a year
- 8 hour shift
- Research
- Mid-level
- Organizational skills
Quick Apply
1d
Senior Product Analyst
Assured —Palo Alto, CA
- $155,000 - $175,000 a year
- Full-time
- Remote
- SQL
- AWS
- Analysis skills
- Health savings account
- Paid holidays
Member Benefits Analyst
CALIFORNIA SCHOOL EMPLOYEES ASSOCIATION —San Jose, CA
- $107,716 - $133,441 a year
- Full-time
- English
- Mid-level
- Office
- Paid holidays
- Health insurance
Financial Analyst
MobiXip —Livermore, CA
- Email
- 5 years
- Finance
- Bachelor's degree
Benefit Analyst
Marsh —Walnut Creek, CA
- $41,200 - $76,800 a year
- Overtime
- Hybrid work
- Microsoft Word
- Basic math
- Research
- Health insurance
- 401(k)
Risk & Insurance Analyst, Energy
Tesla —Palo Alto, CA
- $108,000 - $162,000 a year
- Full-time
- Microsoft Excel
- Customer service
- Mid-level
- Commuter assistance
- Health savings account

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claims analyst jobs near hayward ca

Triage Analyst - Zero Balance (Fully Remote)

Aspirion -
Alameda, CA

Quick Apply

Job Details

Full-time
$25 - $32 an hour
3 days ago

Qualifications

Customer communication
Research
High school diploma or GED
Root cause analysis

Full Job Description

For over two decades, Aspirion has delivered market-leading revenue cycle services. We specialize in collecting challenging payments from third-party payers, focusing on complex denials, aged accounts receivables, motor vehicle accident, workers’ compensation, Veterans Affairs, and out-of-state Medicaid.

At the core of our success is our highly valued team of over 1,400 teammates as reflected in one of our core guiding principles, “Our teammates are the foundation of our success.” United by a shared commitment to client excellence, we focus on achieving outstanding outcomes for our clients, aiming to consistently provide the highest revenue yield in the shortest possible time.

We are committed to creating a results-oriented work environment that is both challenging and rewarding, fostering flexibility, and encouraging personal and professional growth. Joining Aspirion means becoming a part of an industry leading team, where you will have the opportunity to engage with innovative technology, collaborate with a diverse and talented team, and contribute to the success of our hospital and health system partners. Aspirion maintains a strong partnership with Linden Capital Partners, serving as our trusted private equity sponsor.

We are seeking an engaged and driven Healthcare Analyst for our Zero Balance team. As a Healthcare Analyst, you will work closely with your team on assigned project(s) to be a trusted point of contact for our clients and team members. The Healthcare Analyst will support the success of the Zero Balance department by evaluating and reviewing contracts between hospitals and insurance carriers and researching trends and why underpayments are occurring. The ideal candidate for this position will have a demonstrated interest in healthcare and a desire to strengthen their analytical, team, leadership, and client relations skills.

What you will do

Review and interpret hospital contracts with insurance carriers, model claims data, and identify reimbursement discrepancies and revenue recovery opportunities.
Research and monitor federal, state, and payer-specific regulations related to hospital reimbursement methodologies; collaborate with technical teams to develop and implement audit flags that identify emerging underpayment trends.
Analyze large and complex healthcare claims data sets to identify underpayment, denial, and reimbursement variance trends.
Evaluate contract modeling results and validate payment variances by analyzing claim-level data, determining scope, recoverability, and appropriateness for zero-balance audit review.
Identify, analyze, and communicate underpayment trends and revenue recovery opportunities; partner with Customer Success and Client Performance teams to ensure appropriate claims are routed through the recovery pipeline.
Provide revenue intelligence and operational insights to support client performance initiatives, reimbursement optimization, and strategic decision-making.
Identify underpayment and denial root causes and assign appropriate denial categories (e.g., authorization, eligibility, coding, medical necessity, timely filing, registration, billing, payer processing).
Review documentation from payer portals, client systems, provider notes, explanation of benefits (EOBs), remittance advice, and other sources to understand account history and claim status, communicate with insurance carriers and internal stakeholders as needed to clarify claim status, and support the development of comprehensive appeal submissions.
Maintain accurate documentation of denial actions, findings, and escalation activities.
Prioritize denials based on financial impact, aging, contractual requirements, and appeal deadlines.
Route denied claims to the appropriate resolution pathway based on denial type, payer requirements, and supporting documentation.
Adapt quickly to new technologies, software platforms, automation tools, reporting systems, and process enhancements in a rapidly evolving operational environment.
Ensure compliance with payer guidelines, regulatory requirements, and organizational policies.
Work independently and collaboratively to achieve productivity and quality goals.
Follow organizational policies, payer guidelines, and regulatory requirements including HIPAA.

What you will bring

High school diploma or equivalent required
Strong analytical and critical thinking skills with the ability to evaluate denial root causes
Strong written and verbal communication skills
Ability to multi-task and manage competing priorities
Proven ability to learn and adopt new technologies, software applications, and operational processes quickly
Ability to research and interpret insurance information and benefits
Strong attention to detail and accuracy in documentation
Ability to work independently in a fast-paced environment
Reliable attendance and consistent performance

What we would like to see

Bachelor’s degree preferred or equivalent combination of education and experience.
Prior experience in healthcare revenue cycle or denial management environments.
Experience with denial analytics platforms and payer portal navigation.
Experience in identifying denial root causes and applying critical thinking to support accurate triage and routing.
Familiarity with insurance carriers and payer guidelines.
Demonstrated ability to identify trends and process improvement opportunities.
Experience working in a productivity and quality metrics-driven environment.
Remote work experience in a structured environment.
Experience working with EMR systems such as Epic or similar platforms.

Core expectations

Demonstrate integrity and ethics in day-to-day tasks and decision making, operate effectively in the environment and the environment of the work group, maintain a focus on self-development and seek out continuous feedback and learning opportunities
Support Compliance Program by adhering to policies and procedures pertaining to HIPAA, GLBA, FCRA, and other laws applicable to business practices; this includes becoming familiar with Code of Ethics, attending training as required, notifying management when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations
US remote-based colleagues are not permitted to work from a location outside of the United States, at any time, without prior, written approval.
Fully remote position.

Quick Apply

Refine Your Search

claims analyst jobs in hayward ca

Triage Analyst - Zero Balance (Fully Remote)

Customer Operations Claims Analyst

Fraud Detection Analyst, Senior

Staff Data Analyst

Overpayments and Collections Analyst I/II - Limited Term (Open)

Risk Analyst

APeX Claims Analyst

Senior Compliance Analyst - FT- Days - Corporate Compliance @ MV

EPIC APPLICATION ANALYST - MSO

Medical Informatics Analyst, Consultant

RCM Analyst

Claims Analyst or (Senior) Claims & Patient Safety Specialist

Program Analyst (Public Records Specialist)

Enterprise Risk management Analyst (7204U) Ethics, Risk & Compliance Service #85328

Pharmacy 340B Analyst - Pharmacy- 1.0 FT - 8hrs days variable

Senior Product Analyst

Member Benefits Analyst

Financial Analyst

Benefit Analyst

Risk & Insurance Analyst, Energy

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