claims compliance analyst.

National Healthcare company is hiring for a Claims Compliance Analyst to work on location in Whittier, CA

Maintains positive working relationships with our internal and external customers, health plan's, providers and/or members by seeking a partnership approach that will meet the company goals and vision.

The Claims Compliance Analyst will coordinate Health Plan's audits activities with preparation and provide preliminary results on non-compliant claims to the Claims Director.

Assists with an audit control checklist for prevention of claims untimeliness of payment. Collaborates in conjunction with the Managed Care Management Team and other auditors, to ensure QA programs are aligned with claims operations and other areas that have direct impact with claims to prevent non-compliance.

Adheres to internal department standard operating procedures and applies standard industry guidelines in accordance with regulatory agencies (state and federal).

Prepares and submits all monthly, quarterly and as needed reporting to the health plans (Monthly Timeliness, ODAGs, Part C, claims universe, etc.)

Contract for 3 months to start

Start/end time: 7:00 am to 3:30 pm


Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.