California Licensed Medical Claims Analyst

Supporting providers and clients, the remote California Licensed Medical Claims Analyst will conduct comprehensive medical claims research, resolve inquiries, and collaborate with cross-functional teams to enhance operational support. Key responsibilities: Research, analyze, and resolve routine to complex medical claims and provider inquiries using established policies and procedures Manage claims research and correspondence by prioritizing assignments and ensuring timely resolution of issues Collaborate with providers, clients, and leadership to facilitate escalations and support program initiatives Required qualifications: Three or more years of experience in healthcare operations, medical claims processing, or related fields; Medi-Cal or Medicaid experience preferred Experience in researching and resolving medical claims and provider inquiries Strong analytical and decision-making skills with the ability to manage multiple priorities Working knowledge of provider operations and medical claims processing Experience identifying process improvement opportunities and developing practical solutions