A boutique healthcare law firm in Costa Mesa, CA is looking for a motivated problem-solver to join its team as a Claims Analyst. The firm and its employees are dynamic, focused and fast paced, striving for excellence in all they do.

As a Claims Analyst, you will be responsible for accurately and efficiently reviewing contracts, researching healthcare provider claims, thoroughly documenting investigation results and identifying and implementing appropriate and effective resolution strategies.

Job Responsibilities:

• Prioritize voluminous claim review workload
• Validate claim status, claim liability and availability of coverage
• Understand concepts of coverage, insurance contract interpretation and reimbursement methodologies
• Responsible for pricing claims
• Responsible for reviewing and validating coding
• Research and analyze information gathered through investigation to identify reimbursement issues, develop solutions and initiate appropriate claim resolution strategies
• Maintain quality and productivity standards as set by Management
• Influence others using a positive approach
• Work independently with minimal supervision
• Perform special projects as requested
• Ensure compliance with Health Insurance Portability and Accountability Act
• Other duties as assigned

Qualifications / Skills:

• Strong analytical, problem solving and research skills
• Excellent verbal and written communication skills
• Ability to multitask and thrive in a fast-paced work environment
• Strong organizational skills
• Highly detail oriented
• Team player
• Curious personality
• An interest in healthcare and healthcare law and the desire and ability to solve problems

Job Requirements:

• 3-5 years of position specific related work experience (managed care, revenue cycle, data mining and/or legal)
• 3-5 years’ experience working on hospital claims
• Experience with Microsoft Office products
• Experience with healthcare provider claims management software highly preferred
• Government Payor Experience (preferred)
• Strong analytical, problem solving and research skills
• Excellent verbal and written communication skills
• Ability to multitask and thrive in a fast-paced work environment

***Candidate must be able to work onsite at our office daily in Costa Mesa.

Join the team now and you can have direct involvement with our growth and make an impact on how we shape our future and the future of healthcare. Apply now for immediate and confidential consideration.

*The actual base is dependent upon many factors, such as: training, transferable skills, work experience, business needs and market demands. The base pay range is subject to change and may be modified in the future.