2428 Transformation Analyst jobs in Van Nuys,CA

New, Posted 11 hours ago

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Field Sales

Spectrum

El Segundo, CA 90245

$100,000/yr

~ 32 min OnsiteBilingual Preferred

A valid driver's license, car insurance, a satisfactory driving record, and the use of a reliable personal vehicle
High School Diploma or equivalent work experience
Ability to read, write, speak, and understand multiple languages (English and Spanish)
Ability to travel (including during inclement weather) to and from assigned territories and company facilities
Must be able to work evenings and weekends, and as business needs dictate
Spend approximately 90% of time outdoors in all seasons, with potential exposure to inclement weather
Exposure to moderate noise levels
Must be able to work lawfully in the U.S. without employment-based immigration sponsorship, now or in the future

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New, Posted 15 hours ago

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Data Encounter Analyst

TEKsystems

Canoga Park, CA 91304

$28/hr

~ 21 min OnsiteHealth InsurancePaid Time OffRetirement Benefit

Data Encounter Analyst
The Benefits Analyst is responsible for supporting the daily operations, configuration, and maintenance of the medical group's claims processing systems.
This role ensures the accuracy of member benefit setups, eligibility data, claims adjudication, and overall financial integrity.
Maintain and support claims processing systems, including configuration and ongoing system updates
Ensure accurate setup and maintenance of member benefits, eligibility, and provider assignments
Support claims adjudication processes to ensure timely and accurate reimbursement outcomes
Interpret managed care contracts and translate requirements into system configurations and fee schedules
Monitor and ensure data integrity across claims, benefits, and financial systems
Conduct system testing and validation to support enhancements and process improvements
Collaborate cross-functionally with operations, IT, and finance teams to resolve issues and optimize workflows
Analyze data to identify trends, discrepancies, and opportunities for automation and efficiency improvements
Support payment integrity initiatives and financial accuracy of claims processing
Claims system configuration and adjudication experience
Strong knowledge of EZ-Cap
Experience with fee schedule management
Understanding of managed care contracts and DOFR (Division of Financial Responsibility)
Proficiency in data integrity auditing and analysis
Experience with benefits enrollment and eligibility verification
Technical skills in SQL, Microsoft Access, and Excel
Familiarity with ICD-9 and ICD-10 coding
Intermediate level experience within healthcare claims, benefits administration, or managed care environments
This is a Contract position based out of Canoga Park, CA 91304.