Senior Payment Integrity Analyst

Job Category:  Administrative, HR, Business Professionals
Department:  Payment Integrity (309)
Location:  Los Angeles HQ, California, US
Position Type:  Full Time
Requisition ID:  542

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

DUTIES

The Senior Payment Integrity Analyst is responsible for supporting payment integrity solutions focused on improving claim payment accuracy and reducing overall medical spend for LA Care Health Plan. This position will support Payment Integrity by assisting in vendor implementations and configuration, assisting in algorithm/edit customizations, as well as other payment integrity functions.

 

QUALIFICATIONS AND REQUIREMENTS

 

EDUCATION

Required:

High School Diploma

 

Preferred:

Associate's or Bachelor's Degree

 

EXPERIENCE

 

Required:

With High School Diploma: with 6-8 years of experience.

4-6 years participating in healthcare (Medicare, Medicaid, Commercial).

3-5 years of experience with health care data.

 

Preferred:

With Associate's Degree: in related field with 5 years of experience.

 

With Bachelor's Degree: in related field with 3-5 years of experience.

 

With Master's Degree: in related field with 2 years of experience.

 

Experience in project implementation.

 

L.A. Care offer a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program


Job Segment: Medical, Medicare, Medicaid, Healthcare