Associate Analyst, Claims Research (Remote)-Triage

JOB DESCRIPTION Job Summary

Provides entry level analyst support for claims research activities.  Ensures timely and accurate resolution of provider submitted claims issues/inquiries. Leverages understanding of medical claims processing and uses analytical skills to effectively triage issues to facilitate claims investigation or correction. Meets established production and quality standard.  Identifies trends in claims issues to inform process improvements and drive continuous improvement in claims performance and compliance.

Essential Job Duties

• Reviews and analyzes claims-related issues submitted by providers to identify potential root-cause issues; triages issues quickly and accurately.
• Triages issues based on type and complexity, assigning 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 claims 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 related to provider claims research.

Required Qualifications

• At least 1 year of experience in medical claims processing/research and/or health care operations , or equivalent combination of relevant education and experience.
• Basic medical claims processing knowledge.
• Data research and analysis skills.
• Organizational skills and attention to detail.
• Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Customer service skills.
• Problem-solving skills.
• Ability to work independently and as part of a team, and collaborate cross-functionally across a highly matrixed organization.
• Effective verbal and written communication skills.
• Microsoft Office suite (including Excel), and applicable software programs 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: $14.76 - $31.97 / 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. Remote positions are U.S.-based only. Candidates must reside and be authorized to work in the United States. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type Full Time Posting Date 10/07/2026