Claims Analyst jobs in Santa Barbara, CA

• Review, price and release claims associated with the assigned claim types (paper and electronic)
• Review Manual Review reports that suspend for review on all CenCal Health programs
• Review audit reports for all CenCal Health programs
• Analyze current processes and work with Supervisor to automate or improve quality where fit
• Assist with ideas for creation of SCF (System Change Forms) when applicable
• Keep up to date on all CenCal Health policies and provide materials for improvement projects within Department
• Assure all regulatory guidelines are being followed and monitored
• Maintain daily activity log
• Assist with the processing of claims
• Audit and report all billing & error trends found during the course of review and data entry;
• Maintain processes and timelines required by AB1455 Claims Settlement Practices and DHCS Regulations

Other duties and projects as assigned