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EDI Systems Analyst
3 weeks ago
The Judge Group Inc. Los Angeles, United StatesLocation: REMOTE · Salary: $85,000.00 USD Annually - $90,000.00 USD Annually · Description: One of our clients is looking for an experienced EDI Systems analyst to join their growing team · Must Have skills: · • Bachelor's degree in Computer Science, Information Systems, or ...
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EDI Production Support Analyst
1 week ago
VLink Inc Los Angeles, United StatesDescription: · EDI Production Support Analyst · Future duties and responsibilities: · Work in an onshore-offshore model, with 4-5 offshore developers. · Work proficiently in EDI Applications Edifecs · Work with Medicaid and Medicare transactions · Follow engineering standard meth ...
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Medicare Advantage EDI Analyst
1 week ago
UCLA Health Los Angeles, United StatesGeneral Information · Press space or enter keys to toggle section visibility · Work Location: Los Angeles, USA · Onsite or Remote · Flexible Hybrid · Work Schedule · Monday-Friday, 8:00am - 5:00pm PST · Posted Date · 04/30/2024 · Salary Range: $ Annually · Employment Type · 2 - S ...
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Medicare Advantage EDI Analyst
1 week ago
University of California Los Angeles, United StatesTake on a significant role within a world-class health organization. Elevate the operational effectiveness of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health. · As an important member of our Medicare Advanta ...
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Medicare Advantage EDI Analyst
3 weeks ago
University of California Los Angeles, United StatesTake on a significant role within a world-class health organization. Elevate the operational effectiveness of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health. · As an important member of our Medicare Advant ...
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Medicare Advantage EDI Analyst
2 weeks ago
University of California Los Angeles, United States· Take on a significant role within a world-class health organization. Elevate the operational effectiveness of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health. · As an important member of our Medicare Adva ...
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Business Analyst Iii Only W2- 10119
5 days ago
Snaprecuit LLC Los Angeles, United States**Only W2** · **GC or USC ONLY** · **What are the 3-4 non-negotiable requirements of this position?** · Must have 5 years BA, Data Analysis, Claims processing experience · QNXT Experience · Healthcare industry · **What are the nice-to-have skills?** · Managed Care experience · ** ...
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IT Systems Analyst
1 week ago
EOI Service Company Anaheim, United States: · **Job Summary**: · EOI Service Company, a national benefits communication and enrollment firm, has a unique opportunity for an Insurance Systems Analyst in our Anaheim office (or a remote location). This is an exciting opportunity to build a career in a fast-paced and growth- ...
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Report Analyst
6 days ago
Frontline Resources Group Santa Fe Springs, United States**Report Analyst - Job description** · - **DUTIES**:_ · - Responsible for various tasks involving data exports and imports, analysis, and reporting using a variety of sources including SQL, pricing databases, and customer ordering platforms. · - Coordinating with Pricing, RFP / C ...
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Business Analyst IT
3 weeks ago
MedPOINT Management Los Angeles, United StatesJob Description · MedPOINT Management Title: Business Analyst, IT ===== Summary: The HIT department is seeking a Business Analyst to be an advanced professional who can partner effectively with all levels of the organization, lead projects, drive results, proactively identify and ...
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Claiming Analyst Temporary
2 weeks ago
Sycamores LLC Los Angeles, United StatesClaiming Analyst Temporary - Mental Health Billing · Wednesday, February 14, 2024 · JOB SUMMARY: · Sycamores provides a spectrum of equitable mental health services through various programs to multicultural populations of all acuities. Although it serves a variety of consumers, ...
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Claiming Analyst
1 week ago
Sycamores LLC Los Angeles, United StatesTuesday, February 13, 2024 · JOB SUMMARY: · Sycamores provides a spectrum of equitable mental health services through various programs to multicultural populations of all acuities. Although it serves a variety of consumers, the agency focuses primarily on providing care to low-in ...
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Claiming Analyst Temporary
2 days ago
Hathaway Sycamores Los Angeles, United StatesJOB SUMMARY: · Sycamores provides a spectrum of equitable mental health services through various programs to multicultural populations of all acuities. Although it serves a variety of consumers, the agency focuses primarily on providing care to low-income, high at- risk youth. · ...
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Software Engineering Supervisor
3 weeks ago
Insight Global Los Angeles, United StatesA client in Los Angeles, CA are seeking a skilled and passionate Hands-On Full Stack Developer to join their dynamic team. As a key member of their software development group, you will play a pivotal role in designing, developing, and maintaining web applications. Your expertise ...
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Sales Analyst
3 weeks ago
TRUGlobal Los Angeles, United States(Medical device, pharmaceutical, biotech, or other regulated industry experience is mandatory) · The Sales Experience Analyst II will partner with the sales team, customer and field support operations team, IT team, analytics team, finance teams and other teams who support sales ...
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Claiming Analyst Temporary
1 week ago
Sycamores LLC Los Angeles, United StatesClaiming Analyst Temporary - Mental Health Billing · Wednesday, February 14, 2024JOB SUMMARY:Sycamores provides a spectrum of equitable mental health services through various programs to multicultural populations of all acuities. Although it serves a variety of consumers, the ag ...
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Full Stack Development Supervisor
2 weeks ago
Insight Global Los Angeles, United StatesA client in Los Angeles, CA are seeking a skilled and passionate Hands-On Full Stack Developer to join their dynamic team. As a key member of their software development group, you will play a pivotal role in designing, developing, and maintaining web applications. Your expertise ...
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UCLA Los Angeles, United StatesPosition overview · Position title: Scholar of Public Policy · Salary range: A reasonable estimate for this position is $120,000 to $160,000 · Application Window · Open date: February 13, 2024 · Next review date: Wednesday, Apr 10, 2024 at 11:59pm (Pacific Time) · Apply by this d ...
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Claiming Analyst
1 week ago
Sycamores LLC Los Angeles, United StatesTuesday, February 13, 2024JOB SUMMARY:Sycamores provides a spectrum of equitable mental health services through various programs to multicultural populations of all acuities. Although it serves a variety of consumers, the agency focuses primarily on providing care to low-income, ...
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Surgeon - Scientist Faculty, Foot and Ankle
1 week ago
UCLA Los Angeles, United StatesPosition overview · Position title: Surgeon - Scientist Faculty, Foot and Ankle · Salary range: The posted UC salary scales ) set the minimum pay determined by rank and step at appointment. The salary range for this position is $198,700- $626,100. See Table 5 - Summary: This pos ...
Medicare Advantage EDI Analyst - Los Angeles, United States - UCLA Health
Description
Take on a significant role within a world-class health organization. Elevate the operational effectiveness of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health.
As an important member of our Medicare Advantage Operations team, you will be instrumental in maintaining and running processes/jobs for electronic claims and other EDI transactions.
This will involve working with external trading partners, transferring/loading data through secure channels, and testing files from new providers/trading partners.
You will be responsible for claim encounter data submissions and the coordination of business transactions for all HIPPA/CMS standard sets.
You will focus on delivering operational efficiencies and meeting claim data submission requirements.Salary Range:
$71,500 - $154,900 AnnuallyQualifications
We're seeking a self-motivated, detail-oriented, customer-focused leader with:
Bachelor's degree in computer science, information technology, business, or a related field, and five years of experience, or an equivalent combination of education and experience required
Five or more years of experience with CMS processes in a Medicare or managed care environment
Must have 3-5 years of experience with Encounter submission (837 I, P, 999 and 277) to/from CMS is required
Advanced proficiency with SQL, SSIS package, data visualization tools, and Microsoft Office
Knowledge of physician and facility billing practices, appropriate CPT coding initiatives, ICD-10 coding standards, and revenue/HCPCS coding
Extensive experience with claims encounter strategies and processes
Knowledge of claims payment methodologies, adjudication processing, and Federal encounter regulations
Knowledge of encounter regulatory reporting and compliance requirements
Previous vendor management experience
Ability to research and resolve encounter issues
Understanding of the health care model, capitation, and other managed care IPA and provider reimbursement methodologies
Excellent communication, interpersonal, analytical, and problem-resolutions skills
Ability to modify and adapt operational procedures to changing operational needs
Strong leadership, critical thinking, and prioritizing abilities
Ability to develop, implement, and evaluate methods and systems to improve efficiency
Ability to articulate ideas to both technical and non-technical staff
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California.
We are also home to the David Geffen School of Medicine, a highly respected leader in the development of breakthrough medical research and outstanding clinical professionals.
If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.
UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person's unique achievements and experiences to further set us apart.
