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Associate Analyst, Claims Research
Molina HealthcareAZ, United States; Arizona; Michigan; Texas; Milwaukee, Wisconsin; Savannah, Georgia; Racine, Wisconsin; Bowling Green, Kentucky; Warren, Michigan; Tampa, Florida; Kenosha, Wisconsin; Orlando, Florida; Vancouver, Washington; Bellevue, Nebraska; Boise, Idaho; Omaha, Nebraska; Layton, Utah; Cleveland, Ohio; Santa Fe, New Mexico; Meridian, Idaho; Tucson, Arizona; Idaho; Detroit, Michigan; Everett, Washington; Sioux City, Iowa; Phoenix, Arizona; Madison, Wisconsin; Louisville, Kentucky; Utah; Florida; Ohio; Idaho Falls, Idaho; Scottsdale, Arizona; Houston, Texas; Spokane, Washington; Tacoma, Washington; Green Bay, Wisconsin; Iowa City, Iowa; Orem, Utah; Albuquerque, New Mexico; Syracuse, New York; Grand Rapids, Michigan; Buffalo, New York; Cincinnati, Ohio; Columbus, Georgia; Wisconsin; Washington; Grand Island, Nebraska; Austin, Texas; Caldwell, Idaho; Owensboro, Kentucky; West Valley City, Utah; St. Petersburg, Florida; Ann Arbor, Michigan; Dayton, Ohio; Akron, Ohio; Las Cruces, New Mexico; Sterling Heights, Michigan; Mesa, Arizona; Columbus, Ohio; Augusta, Georgia; New York; Georgia; New Mexico; Albany, New York; Davenport, Iowa; Chandler, Arizona; Des Moines, Iowa; Cedar Rapids, Iowa; Atlanta, Georgia; Iowa; Miami, Florida; Bellevue, Washington; Lincoln, Nebraska; Nampa, Idaho; Jacksonville, Florida; San Antonio, Texas; Dallas, Texas; Fort Worth, Texas; Kearney, Nebraska; Kentucky; Nebraska; Yonkers, New York; Macon, Georgia; Provo, Utah; Covington, Kentucky; Salt Lake City, Utah; Lexington-Fayette, Kentucky; Rio Rancho, New Mexico; Roswell, New Mexico; Rochester, New York Job ID 2034059
Job Summary
Provides entry level analyst support for claims research activities. This role plays a pivotal role in ensuring the timely and accurate resolution of provider-submitted claims issues. This role requires a keen understanding of medical claims processing, strong analytical skills, and the ability to effectively triage issues to the appropriate department for further investigation or correction. This is a production-based role, with clear expectations for meeting production and quality standards.
Job Duties
- Reviews and analyzes claims-related issues submitted by providers to identify potential root causes quickly and accurately.
- Triages issues based on type and complexity, assigning them to the appropriate department or team for further research or correction.
- Leverages knowledge of claims processing workflows, billing practices, and regulatory guidelines to provide accurate assessments.
- Meets quality and production goals.
- Maintains detailed records of claim reviews and resolutions.
- Identifies trends in submitted issues to inform process improvements and reduce recurring errors.
- Provides feedback and recommendations for process improvements.
- Completes training and development activities to stay current with industry standards and best practices.
Job Qualifications
REQUIRED QUALIFICATIONS:
- At least 1 year of experience in claims processing or operations or equivalent combination of relevant education and experience
- Basic knowledge of medical billing and basic claims processes.
- Problem-solving skills
- Verbal and written communication skills and ability to collaborate
- Ability to work independently and as part of a team
- Microsoft Office suite/applicable software program(s) proficiency
PREFERRED QUALIFICATIONS:
- Experience with process improvement methodologies.
- Knowledge of industry regulations and compliance standards.
- Familiarity with systems used to manage claims inquiries and adjustment requests
- Understanding of billing and coding procedures
- Experience with Medicaid, Medicare, and Marketplace claims
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $38.37 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type Full Time Posting Date 10/16/2025Job Alerts
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