Senior Claims Operations Analyst – Encounters

🕒 July 29

🏄 California – Remote

🏄 California – Remote

💵 $91.7k - $128.3k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Gold Coast Health Plan

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2011

At Gold Coast Health Plan, we are driven to create the health plan of the future - today. We are disrupting the conventions of the health care industry by creating and applying leading-edge solutions to its many challenges.

📋 Description

• Serve as the technical subject matter expert for Encounter Operations • Monitor encounter production, submission, acceptance, rejection, timeliness, and data quality • Lead root cause analysis of encounter processing issues • Collaborate with claims operations, IT, vendors, and regulatory agencies • Prepare complex analyses, executive summaries, and reports

🎯 Requirements

• High School Graduate or GED • 5 years of experience in encounter operations or related field • Knowledge of Medi-Cal, Medicare, D-SNP programs, and managed care operations • Experience with healthcare claims processing, medical billing, and coding methodologies • Technical skills in MS Office products, advanced Excel

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work hours • Paid time off • Professional development