*Clinical Operations Analyst - Claims

Overview

 

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Desert Valley Medical Group is affiliated with Desert Valley Hospital, one of the nation’s “100 Top Hospitals” and “A” rated for patient safety. We offer incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

 

Desert Valley Hospital, along with Desert Valley Medical Group, offers key services to the community including heart care, emergency services, labor and delivery, surgical services and more. For more information visit www.DesertValleyHospital.com.

 

Desert Valley Medical Group offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs.

 

Our Total Rewards package includes, but is not limited to:

• Paid Time Off
• 401K retirement plan
• Outstanding Medical
• Dental
• Vision Coverage
• Tuition Reimbursement
• Many more Voluntary Benefit Options!

Responsibilities

Supports eligibility verification, claims operations, and healthcare systems workflows for Business office operations and Managed care departments. Assists with user support, workflow coordination, operational trouble shooting, payer communication, and reporting activities related eligibility, claims, and healthcare operational systems. Works with operational teams, IT staff, Vendors, and health plans to support system functionality, workflow continuity, and process improvement initiatives.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

 

Bachelor’s degree in Information Science, Business Discipline, Healthcare Management, Health Information management or equivalent experience preferred.

Current Microsoft SQL Certification preferred.

2 years work experience in a Managed Care setting required with emphasis on Analytics, EDI, X12, FTP, and data mining, preferred.

Interpersonal skills necessary to deal with and establish working relationships with physicians, hospital personnel, vendors, trading partners, and co-workers.

#LI-DNI

Pay Transparency

Desert Valley Medical Group offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $31.00 to $40.70. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf