Clinical Data Analyst

7 days ago


Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

Role Overview

The Clinical Data Analyst will be responsible for conducting thorough reviews of medical records and healthcare claims to identify coding errors and billing discrepancies. This role requires a strong understanding of medical coding, billing practices, and healthcare regulations.

Responsibilities:

  • Conduct thorough reviews of medical records and healthcare claims
  • Identify coding errors and billing discrepancies
  • Provide guidance and mentorship to junior team members

Qualifications:

  • Bachelor's degree in Medical Billing/Medical Coding, Nursing, Healthcare Administration, or related field from an accredited institution
  • Minimum 5 years of experience performing medical reviews in support of a healthcare Special Investigations Unit
  • Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), or Certified Coding Specialist (CCS) certification
  • Possession of an active, unrestricted, and unencumbered RN license issued by the California BRN

Benefits Package:

  • Competitive salary with annual merit increase
  • Team bonus opportunities
  • Generous paid time off- vacation, holidays, sick
  • State of the art fitness center on-site
  • Medical Insurance with Dental and Vision


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