Job Information
Actalent Claims Compliance Analyst in Whittier, California
Job Title: Claims Compliance AnalystJob Description
The Claims Compliance Analyst is responsible for coordinating audit activities related to Health Plan compliance. This role involves preparing and providing preliminary results on non-compliant claims to the Claims Director.
Responsibilities
Assist in developing an audit control checklist to prevent untimely resolution of claims.
Collaborate with the Managed Care Management Team and other auditors to ensure quality assurance programs align with claims operations and other related areas, preventing non-compliance.
Adhere to internal department standard operating procedures and apply industry guidelines in accordance with state and federal regulatory agencies.
Prepare and submit monthly, quarterly, and ad-hoc reports to health plans, including Monthly Timeliness, ODAGs, Part C, and claims universe reports.
Essential Skills
Experience in compliance, claims management, and claims analysis.
Familiarity with ODAGs (Organization Determinations, Appeals, and Grievances for Medicaid and Medicare).
Knowledge of handling non-compliant claims.
Additional Skills & Qualifications
Experience in Managed Care.
Understanding of claims processes.
Work Environment
The work environment includes a structured schedule from 7:00 am to 3:30 pm. The role offers benefits such as Abenity and Care Roadmap.
Job Type & Location
This is a Contract to Hire position based out of Whittier, CA.
Pay and Benefits
The pay range for this position is $21.00 - $28.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully onsite position in Whittier,CA.
Application Deadline
This position is anticipated to close on Mar 13, 2026.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.