Top 117 Processing analyst Jobs in Costa Mesa, Ca

Claims Analyst
Clever Care Health Plan —Huntington Beach, CA
- $88,000 - $100,000 a year
- Full-time
- Hybrid work
- Background check
- Writing skills
- Mid-level
Analyst
Advantage Technical —Fountain Valley, CA
- $35 - $44 an hour
- Temporary
- Mid-level
- Analysis skills
- Bachelor's degree
- Health savings account
- AD&D insurance
Quick Apply
Quality Assurance Analyst
University of California, Irvine —Irvine, CA
- $97,000 - $182,200 a year
- Full-time
- Background check
- Nursing
- Customer service
- Health insurance
- Retirement plan
Data Processing Analyst I
Norman International Inc. —La Palma, CA
- $22 an hour
- Full-time
- Office
- Bachelor's degree
- Organizational skills
- Paid holidays
- Disability insurance
Quick Apply
Data Analyst — Game Analytics (Chinese Mandarin Speaker)
Bitus Labs —Irvine, CA
- From $80,000 a year
- Full-time
- Computer Science
- Office
- 3 years
- Health insurance
- Dental insurance
Quick Apply
Human Resources and Documentation Analyst
Vista Paint Corporation —Fullerton, CA
- $20 - $23 an hour
- Full-time
- Mid-level
- Office
- Administrative experience
- Health savings account
- Health insurance
Quick Apply
9d
SAP/CAPEX Analyst
Belcan —Santa Ana, CA
- $43.33 an hour
- Contract
- 5 years
- Mid-level
- Bachelor's degree
- Paid holidays
- Health insurance
Quick Apply
4d
Applications Functional Analyst, Sr
Ventura Foods —Irvine, CA
- $110,953.00 - $144,461.10 a year
- Hybrid work
- Computer science
- Oracle
- Computer Science
- Profit sharing
- Paid holidays
Quick Apply
Sr. Program Analyst
General Dynamics Information Technology —California
- $93,662 - $103,500 a year
- Hybrid work
- 5 years
- Bachelor of Science
- Bachelor's degree
- Paid holidays
- 401(k) matching
Healthcare Data Analyst
Astiva Health —Orange, CA
- $85,000 - $115,000 a year
- Computer Science
- Mid-level
- Analysis skills
Quick Apply
Oracle ERP Software Business Analyst
C3 Business Solutions —Newport Beach, CA
- $85,000 - $130,000 a year
- Full-time
- Hybrid work
- Oracle
- Word processing
- Mid-level
- Profit sharing
- Health insurance
Fund Banking Analyst
Stifel —Irvine, CA
- $70,000 - $100,000 a year
- Full-time
- Office
- Finance
- Analysis skills
- Health insurance
- Dental insurance
Business Operations Analyst
Stretto —Irvine, CA
- $28.85 - $31.25 an hour
- Full-time
- Research
- Mid-level
- Office
Quick Apply
Data Analyst Sr, Finance - Encounter Data - Covered California
CalOptima —Orange, CA
- Weekends as needed
- Background check
- Microsoft Outlook
- Writing skills
- Tuition reimbursement
- Paid time off
13d
Administrative Analyst - Public Works Operations
City of Anaheim, CA —Anaheim, CA
- $95,020 - $142,530 a year
- Full-time
- Background check
- Word processing
- English
- Health insurance
- Dental insurance
9d
Financial Analyst III (Insurance Risk)
CalOptima —Orange, CA
- Weekends as needed
- Background check
- Microsoft Outlook
- Writing skills
- Tuition reimbursement
- Paid time off
11d
CRE Credit Analyst - Irvine, CA
California Bank & Trust —Irvine, CA
- $39 - $48 an hour
- Word processing
- Research
- Mid-level
- Profit sharing
- Paid training
1d
Warehouse Lending Analyst
Banc of California —Santa Ana, CA
- $21.39 - $32.21 an hour
- Mid-level
- Office
- High school diploma or GED
- Paid parental leave
- Health savings account
10d
Specialist, Program Finance Analyst
L3Harris Technologies —Anaheim, CA
- $67,000 - $141,000 a year
- Research
- Mid-level
- Office
- Paid holidays
- Disability insurance
Account Analyst
United WestLabs —Santa Ana, CA
- $26 - $33 an hour
- Full-time
- Research
- Mid-level
- Office
Quick Apply

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Claims Analyst

Clever Care Health Plan -
Huntington Beach, CA

Apply Now

Job Details

Full-time
$88,000 - $100,000 a year

Qualifications

Managed care
Managed care organization experience
High school diploma or GED
Health insurance knowledge
Task prioritization

Full Job Description

Applicants must be located in Southern California in Los Angeles or Orange County,

Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.

Who Are We? ✨

Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values.

Why Join Us?

We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.

Job Summary

The Claims Analyst will work with the Senior Director of Medicare Operations in identifying potential areas for process improvement initiatives to support development of automation, payment accuracy, audit activities, business rules and P&Ps. Claim analyst is responsible for the end to end process for any configuration and automation projects

Functions & Job Responsibilities

Includes claims systems utilization, capacity analyses/planning and reporting including claims-related business and systems analysis
Excellent analytical, problem solving and troubleshooting activities.
Must be able to analyze requirements for any Claim related projects
Provide configuration support based on business needs including but not limited to DOFR, Benefits, and MOOP.
Evaluate and Analyze any business needs including but not limited to DOFR, Benefits, and MOOP related to Claims Department.
Review and recommend improvement to current configuration
Document and Report to Senior Claims analyst and Director of Medicare Operations
Perform Test Cases
Run Test, study and analyze result, and troubleshoot if necessary
Ability to pull and analyze reports necessary to support claim department needs
Validating accuracy of reports produced and submitted by the Claims Department.
Assists in preparing and reviewing cases for regulatory and other health plan reports and requirements.
Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
Assists in validating claim compliance reports
Create Business Requirement Document as needed
Create CMS Reports as needed by Director of Operations
Manage and support new projects and regulatory updates in accordance with CMS

Qualifications

Education/Experience:

High School diploma or equivalent required. Associate degree or an equivalent combination of education and claims processing experience preferred. Bachelor’s degree in related field (preferred).
2 to 5 years of experience in a managed care claims processing environment required
Demonstrate knowledge of applicable claims processes (e.g., end-to-end claims cycle, auto-adjudication, manual work processes, payment methodologies, rework/adjustment processes)
Terminology, CPT, revenue codes, ICD10, HCPCS codes as it relates to claims processing adjudication. Core claims processing systems and healthcare authorization systems.

Skills:

Perform in a fast-paced environment and work under pressure.
Communicate clearly and concisely, both verbally and in writing to individuals of diverse backgrounds.
Organize, plan and prioritize work activities, possess analytical and problem-solving skills.
Troubleshoot claims adjudication problem areas.
Encourage and utilize suggestions and new ideas.
Comprehend and interpret provider contracts and Divisional Financial of Responsibility (DOFR).
Utilize and access computer and appropriate software (e.g., Microsoft: Word, Excel, PowerPoint) and job-specific applications/systems (e.g., EZCAP Claims Processing System and Authorization system) to produce correspondence, charts, spreadsheets, and/or other information applicable to the position.

Wage Range: $88,000.00 to $100,000.00 per year

Physical & Working Environment.

Physical requirements needed to perform the essential functions of the job, with or without reasonable accommodation:

Must be able to travel when needed or required
Ability to operate a keyboard, mouse, phone and perform repetitive motion (keyboard); writing (note-taking)
Ability to sit for long periods; stand, sit, reach, bend, lift up to fifteen (15) lbs.

Ability to express or exchange ideas to impart information to the public and to convey detailed instructions to staff accurately and quickly.

Work is performed in an office environment and/or remotely. The job involves frequent contact with staff and public. May occasionally be required to work irregular hours based on the needs of the business.

Clever Care Health Plan is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

Salary ranges posted on the job posting are based on California wages. Salary may be higher or lower depending on the candidate’s state residency.

#LI-Hybrid

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Refine Your Search

processing analyst jobs in costa mesa, ca

Claims Analyst

Analyst

Quality Assurance Analyst

Data Processing Analyst I

Data Analyst — Game Analytics (Chinese Mandarin Speaker)

Human Resources and Documentation Analyst

SAP/CAPEX Analyst

Applications Functional Analyst, Sr

Sr. Program Analyst

Healthcare Data Analyst

Oracle ERP Software Business Analyst

Fund Banking Analyst

Business Operations Analyst

Data Analyst Sr, Finance - Encounter Data - Covered California

Administrative Analyst - Public Works Operations

Financial Analyst III (Insurance Risk)

CRE Credit Analyst - Irvine, CA

Warehouse Lending Analyst

Specialist, Program Finance Analyst

Account Analyst

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