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Claim Analyst Jobs in California (NOW HIRING)

myPlace Health

Claims Analyst

Los Angeles, CA · On-site

This position researches and resolves complex claim issues, monitors electronic claim activity ... The Claims Analyst works collaboratively with providers, internal departments, and external vendors ...

myPlace Health

Claims Analyst

Los Angeles, CA · On-site

$57 - $70/hr

This position researches and resolves complex claim issues, monitors electronic claim activity ... The Claims Analyst works collaboratively with providers, internal departments, and external vendors ...

Scanhealthplan

Claims Analyst

Los Angeles, CA · On-site

This position researches and resolves complex claim issues, monitors electronic claim activity ... The Claims Analyst works collaboratively with providers, internal departments, and external vendors ...

Prosper-Services-LL

Claims Analyst

Compton, CA · On-site

$63 - $76/hr

This position researches and resolves complex claim issues, monitors electronic claim activity ... The Claims Analyst works collaboratively with providers, internal departments, and external vendors ...

New

AArete

Analyst, Claims Analytics

El Segundo, CA · On-site

$82K - $97K/yr

Description Analyst, Claims Analytics AArete is one-of-a-kind when it comes to consulting firm culture. We're a global, innovative management and technology consulting firm with offices in the U.S ...

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Claim Analyst information

See California salary details

$14

$27

$51

How much do claim analyst jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for claim analyst in California is $27.03, according to ZipRecruiter salary data. Most workers in this role earn between $19.90 and $31.06 per hour, depending on experience, location, and employer.

What is a claim analyst?

A claims analyst works for an insurance company, government agency, or medical billing department. As a claims analyst, your responsibilities include reviewing insurance claims filed by policyholders to ensure they are accurate and complete, that the individual understands their benefits, and that the policies cover the claims. Your duties include monitoring each claim throughout the process, determining reimbursement eligibility, negotiating payments to each party, and following up to ensure the parties make their payments. You then provide documentation and report the necessary information to each party. You are the primary contact for groups and members to answer questions and solve any issues. You may work in a variety of medical and insurance subsets in the claims industry, like dental or vision health, disability, and even construction.

What are the key skills and qualifications needed to thrive as a claim analyst?

To thrive as a Claim Analyst, you need strong analytical skills, attention to detail, and a background in finance, insurance, or a related field, often supported by a relevant degree or certificate. Familiarity with claims management software, data entry systems, and sometimes industry-specific regulations or certifications like AIC is typical. Strong communication, problem-solving abilities, and customer service skills help you resolve issues efficiently and build trust with clients. These competencies are crucial for ensuring accurate claim evaluations, minimizing errors, and providing excellent service in a fast-paced environment.

How does a claim analyst typically collaborate with other departments during the claims review process?

Claim Analysts frequently work closely with teams such as underwriting, customer service, and legal to ensure accurate and timely resolution of claims. They often need to clarify policy details with underwriters, gather additional information from customer service representatives, and consult with legal advisors on complex or disputed cases. Effective communication and teamwork are essential, as these collaborations help ensure that claims are processed in compliance with company policies and regulatory requirements. This cross-functional interaction also provides valuable learning opportunities and can support career advancement within the insurance industry.

How much do claim analysts make in the US?

Claim analysts in the US typically earn a median annual salary of around $50,000 to $70,000, depending on experience, location, and industry. Entry-level positions may start lower, while experienced analysts or those with specialized skills can earn higher salaries and bonuses.

Is being a claim analyst hard?

Claim analysts review insurance claims to determine coverage and payout amounts, which requires attention to detail, analytical skills, and knowledge of insurance policies. The job can involve repetitive tasks and working under deadlines, but it generally depends on the complexity of claims and the individual's experience. Training and certifications can help improve efficiency and understanding of the role.
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Claim Analyst jobs near you
Infographic showing various Claim Analyst job openings in California as of August 2026, with employment types broken down into 84% Full Time, 10% Part Time, and 6% Contract. Highlights an 79% Physical, 8% Hybrid, and 13% Remote job distribution, with an average salary of $56,228 per year, or $27 per hour.

Claims Analyst

myPlace Health

Los Angeles, CA • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 10 days ago

Job description

myPlace Health is built around a simple but powerful belief: older adults deserve the support they need to live safely, independently, and with dignity in their own communities. As a PACE (Program of All Inclusive Care for the Elderly) organization backed by SCAN Group, myPlace Health brings together customized medical care, social activities, and daily support for participants and their families - all under one roof.
Our centers are more than healthcare facilities. They are vibrant community hubs where participants are known by name, valued, and supported as whole people. Behind that experience is a dedicated, interdisciplinary team working together to coordinate care, remove barriers, and improve quality of life for some of the most medically and socially complex populations.
For employees, myPlace Health offers the opportunity to do deeply meaningful work in a highly collaborative setting. Team members are encouraged to contribute innovative ideas, and grow alongside a mission that prioritizes compassion, respect, and impact. The result is a culture where people feel connected-to their colleagues, their participants, and the communities they serve.
At myPlace Health, work is more than a job. It's a shared commitment to honoring what matters most.
The Claims Analyst is responsible for the accurate, timely, and compliant processing and adjudication of professional, institutional, and ancillary claims. This position researches and resolves complex claim issues, monitors electronic claim activity, maintains claims-related provider and reimbursement configurations, and identifies trends that may affect payment accuracy. The Claims Analyst works collaboratively with providers, internal departments, and external vendors to resolve claims issues, support encounter-data accuracy, and recommend process improvements in accordance with provider contracts, payment policies, and applicable CMS, DHCS, PACE, and organizational requirements.
RESPONSIBILITIES:
  • Review and adjudicate professional, institutional, and ancillary claims in accordance with provider contracts, benefit plans, regulatory requirements, and payment policies.

  • Research and resolve suspended, pended, denied, or incorrectly processed claims requiring manual intervention or additional analysis.
  • Monitor claims activity to help ensure claims are processed accurately and within applicable CMS, DHCS, and internal timely-payment requirements.
  • Monitor daily electronic data interchange activity, identify transmission failures, and coordinate issue resolution with vendors and internal stakeholders.
  • Maintain provider records, fee schedules, reimbursement methodologies, contract terms, and related configuration within the claims processing system.
  • Validate claims configuration updates following contract implementations, reimbursement changes, or system updates.
  • Respond to provider inquiries regarding claim status, payment determinations, denials, and claims research.
  • Identify trends related to billing, utilization, payment accuracy, provider behavior, and recurring claims issues, and escalate findings as appropriate.
  • Participate in root-cause analysis and recommend workflow or process improvements that support automation, payment accuracy, and operational efficiency.
  • Support encounter-data accuracy, claims testing, operational reporting, and internal or external audits by researching claims and gathering required documentation.

  • We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
  • Actively support the achievement of myPlace Health's Vision and Goals

  • All other duties as assigned.

QUALIFICATIONS & EXPERIENCE:
  • Minimum of five years of experience in health plan claims administration.

  • Strong knowledge of healthcare claims processing systems; experience with QuickCap is preferred.
  • Knowledge of electronic data interchange workflows and coordination of benefits.
  • Understanding of CMS and DHCS requirements related to claims processing, timely payment, and encounter-data submission.
  • Experience researching and resolving complex claims issues, including suspended, pended, denied, or incorrectly processed claims.
  • Ability to interpret provider contracts, reimbursement methodologies, fee schedules, benefit plans, and payment policies.
  • Strong analytical, problem-solving, and root-cause analysis skills.
  • Strong written and verbal communication skills.
  • Proficiency in Microsoft Excel, Power BI, or similar reporting and data-analysis tools.

  • Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field; an equivalent combination of education and relevant claims experience may be considered.

Experience Preferred:
  • 5-7 years of related experience

  • Experience working in a PACE, Medicare Advantage, or Medi-Cal managed-care environment.
  • Experience with Athena, VisibilEDI, or integrations between electronic medical record and claims-processing platforms.
  • Working knowledge of payment-integrity concepts, including modifier validation, no-downcoding requirements, and overpayment recovery.
  • Experience supporting claims audits, system testing, configuration validation, and process-improvement initiatives.

What's in it for you?
Base salary range: $63,352.00 per year
Work Mode: Onsite
An annual employee bonus program
Medical, Dental, Vision coverage
Generous paid-time-off (PTO)
11 paid holidays per year, plus 1 additional floating holiday
Excellent 401(k) Retirement Saving Plan with employer match.
Robust employee recognition program
Robust Wellness Program
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