Claims Compliance Analyst

Pacer Staffing
Whittier, CA

Job Title: Claims Compliance Analyst

Profession: Non-Clinical - Finance/Accounting

Specialty: Claims Processor


Schedule

Shift: Day 5x8-Hour (07:00 - 15:30)

Block Schedules: No

Contract Details


Start Date: 05/11/2026

Job Duration: 13 weeks (3 months per overview)

Onsite/Remote: Onsite

Location: 9557 Greenleaf Ave, Whittier, CA 90601

Facility Guidelines


COVID-19 Vaccine: Not Required

Flu Vaccine: Required (Medical/Religious Exemptions and Declinations Allowed)

Position Summary

Maintains positive working relationships with internal and external customers, health plans, providers, and/or members by seeking a partnership approach that aligns with company goals and vision.


Key Responsibilities

Coordinates health plan audit activities, including preparation and preliminary results on non-compliant claims to the Claims Director.

Assists with audit control checklists to prevent claims payment untimeliness.

Collaborates with Managed Care Management Team and auditors to align QA programs with claims operations and related areas, preventing non-compliance.

Adheres to internal SOPs and industry guidelines per state/federal regulatory agencies.

Prepares and submits monthly, quarterly, and ad-hoc reports to health plans (e.g., Monthly Timeliness, ODAGs, Part C, claims universe).

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