Business Systems Analyst: Hoag Clinic Claims & Enrollment
Hoag Health System
Business Systems Analyst: Hoag Clinic Claims & Enrollment Job Description The Business Systems Analyst plays a critical role in supporting advanced analytics and data driven decision making across Hoag Clinic operational departments, including but not limited to Member Services, Quality, Utilization Management, Claims, Medical Management, Clinical Services, and Eligibility. This role is responsible for designing developing and maintaining complex analytical solutions including Power BI dashboards enterprise reports and scalable data models. The analyst will work extensively with Power Query and SQL to extract transform and model data from multiple source systems and will be expected to independently translate complex business questions into actionable insights. The ideal candidate has strong hands‑on experience with Power BI, Power Query and SQL and is comfortable working with large healthcare datasets end to end from data ingestion and transformation through visualization and presentation. Responsibilities Primary Duties and Responsibilities Design develop and maintain advanced Power BI dashboards semantic models and reports used by operational and clinical leadership Use Power Query extensively to extract transform cleanse and combine data from multiple source systems Write optimize and maintain complex SQL queries views and datasets to support reporting and analytics Partner with business stakeholders to translate operational and regulatory requirements into scalable analytical solutions Perform deep dive analysis across claims referrals eligibility and utilization data to identify trends anomalies and operational risks Ensure data accuracy consistency and integrity across all reporting layers including source transformation and visualization Collaborate with IT Strategic Analytics and external partners to improve data pipelines data availability and performance Create and maintain documentation for data sources transformations calculations business rules and reporting definitions Serve as a subject matter expert for Power BI Power Query and SQL within the department Stay current on Power BI feature releases advanced modeling techniques and healthcare analytics best practices Perform other duties as assigned Qualifications Education and Experience Bachelor’s degree in Data Analytics Information Systems Business or equivalent practical experience 3 plus years of hands‑on experience in data analytics business intelligence or reporting roles Strong hands‑on experience using Power BI including Power Query data modeling DAX and visualization best practices Strong SQL skills with experience querying and transforming complex relational datasets Experience working with healthcare data including claims referrals eligibility or utilization highly preferred Solid understanding of data warehousing concepts star schema and reporting optimization Proven ability to independently manage multiple analytics deliverables from requirements through delivery Strong analytical critical thinking and problem‑solving skills Excellent communication skills with the ability to present data insights to non‑technical audiences Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives. #J-18808-Ljbffr
- ...Responsibilities The Utilization Nurse utilizes clinical expertise, discretion, and independent... ...and practices, focusing on the needs of Hoag Hospital and its affiliates (the “... ...incoming referrals, Pre-Service, Retro and Post Claims requests. The UM Nurse will review the...Claims
- Applications Analyst II - Epic: IT Hoag Clinic Newport Beach, CA, United States Job Description Primary Duties... ...of the customer as well as business needs of Hoag. Collaborates with key... ...members of the business teams to optimize system configuration, function and access....SuggestedWork at officeLocal areaShift work
$35.79 - $55.35 per hour
...Hoag Clinic Contact Center Supervisor The supervisor of Member Services is responsible for... ...through the healthcare delivery system. The supervisor will assist with outreach... ...collaborate closely with Revenue Cycle and Claims departments to assist with inquiries and...ClaimsFull timeWork at officeLocal areaRemote workShift work- ...MUST HAVE: 2 years of experience in ambulatory/clinic setting Epic experience DEA required Clean background and no malpractice claims BLS or ACLS Ambulatory, outpatient setting Coverage Schedule: M - F (8 hours) 8a-12p, 1p-5p Patient Age Group: Adults...Claims
$1,080 per month
...Details Client Name Hoag Memorial - Red Hill Clinic Job Type Local Offering... ...amount of reimbursement by evaluating claims at the contract rate with the use of... ...and e?ectively uses patient accounting systems. • Documents all calls and actions...ClaimsHourly payWeekly payContract workLocal areaMonday to FridayShift workDay shift- ...Hoag Health System is seeking a Business Systems Analyst to support advanced analytics and data-driven decision-making across operational departments. This role involves designing, developing, and maintaining complex analytical solutions, focusing on Power BI dashboards...Claims
- ...Manager of Enrollment & Reconciliation - HealthCare Support is seeking a Manager of Enrollment & Reconciliation... ...files, and ensures alignment between internal systems and downstream partners like PBMs, claims, and finance. Identifies discrepancies, maintains...ClaimsLocal areaImmediate startMonday to Friday
$75 - $90 per hour
...about us: A leading urgent care and occupational medicine clinic committed to providing high-quality healthcare services. Job... ...Complete necessary paperwork related to workers' compensation claims and occupational health services. Qualifications: Current...ClaimsLocal area$75 - $90 per hour
...about us: A leading urgent care and occupational medicine clinic committed to providing high-quality healthcare services. Job... ...Complete necessary paperwork related to workers' compensation claims and occupational health services. Qualifications: Current...ClaimsLocal area- ...to maintain high standards of business practice. This job... ...accurate documentation in billing systems, and supports internal teams... ...compassionate manner. Submit claims to insurance companies electronically... ...practices. Coordinate with clinical, administrative, and authorization...ClaimsWork at office
$260k - $325k
...Medical Directors spend most of their time clinically treating patients; the remaining time is... ...improvements and building the center business with the Center Leadership Team. This role... ...CME Time (annually) 6 Paid Holidays Claims Based Medical Malpractice Coverage, including...ClaimsLocal areaRelocation package$54.4 - $85.88 per hour
...Description The Senior Claims Manager is responsible for day-... ...claims in accordance with the System's claims program policies and... ...Qualifications: ~ Bachelor's Degree in Business Administration, Finance, or a... ...50 hospitals, over 1,000 clinics and a full range of health...ClaimsMinimum wageFull timeWork at officeLocal areaShift work$67.89k - $90.93k
...our growing outpatient clinics, focused on the well-being... ...We are seeking a Data Analyst to improve patient... ...medical, financial, and claims data into actionable insights... ...healthcare medical systems, specifically EPIC and... ...provides data that meets business requirements....ClaimsFull timeRemote workMonday to Friday1 day per week- ...Commercial Patient Account Rep Denial Rep - Commercial Claims Commercial Patient Account Representative, Senior is responsible for follow up on denied commercial insurance claims to ensure that PFS is capturing all revenues as timely and efficiently as possible. This...Claims
- Sober Partners in Newport Beach, CA is seeking a Billing Specialist to manage billing processes for clients, ensuring accuracy in claim submissions and insurance verifications. Ideal candidates should possess experience in medical billing, strong organizational skills,...Claims
$29.2 - $42.33 per hour
...nonprofit integrated health system that includes four leading hospitals... ...of managed care and the business segments. # Knowledge and... ...needs. # Ability to understand claims and work with patients to... ...plans to ensure patients are enrolled appropriately. # Correctly...ClaimsFull timeFlexible hoursShift workNight shift- A leading claims adjusting company is seeking Independent Insurance Claims Adjusters in California. This rewarding career path offers flexibility... ...professionally. Contact us today to seize this opportunity and enroll in our training programs. #J-18808-Ljbffr MileHigh Adjusters...ClaimsFlexible hours
- A prominent insurance adjusting firm is seeking Independent Insurance Claims Adjusters in Costa Mesa, California. This opportunity offers flexibility and autonomy while helping clients recover from unforeseen events. Candidates should be licensed and capable of managing...ClaimsFlexible hours
$20 - $25 per hour
...Veros Credit is seeking an Insurance Claims Specialist in Santa Ana, California to manage auto loan accounts and handle claims for physical damage and total losses. The role requires 3+ years of insurance claims experience and English/Spanish bilingualism. Compensation...ClaimsHourly pay$76.2k - $151k
...government clients modernize their Human Capital Management (HCM) and payroll systems. The ideal candidate will bring a strong background in management consulting, a passion for solving complex business challenges, and the ability to lead teams and drive results. Key...Work at officeLocal areaWorldwideFlexible hours- Ally Financial Inc. is seeking an Insurance Claim Advocate based in Costa Mesa, CA. This role involves serving as the main contact for dealer partners navigating the claims process, ensuring smooth communications, and providing outstanding service. The ideal candidate will...ClaimsWork at officeRemote work
- ...IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and... ...Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives. This...Claims
- ...Hoag Health System is seeking a Collector in Costa Mesa, CA, to resolve payments and assist with accounts. The... ...relevant experience, particularly in hospital business or customer service. The role involves evaluating claims, interpreting benefits, and ensuring proper billing...ClaimsDay shift
- ...LLC. in Fountain Valley, California is seeking an experienced Analyst I Customs to manage and prepare documentation for US Customs. This... ..., and ensuring documents are accurately named and grouped for claims. The ideal candidate will possess 3+ years of related...ClaimsHourly pay
$90k - $110k
...innovation.Job SummaryThe Manager, Enrollment & Reconciliation works to... ...to support operations and business decisions related to the capture... ...files to internal enrollment systems.Owns enrollment and payment... ...and downstream vendors (PBM, claims, finance), and ensuring discrepancies...ClaimsWork at officeRemote work$166k - $220k
...Warfighting Systems Analyst, Maritime Costa Mesa, California, United States Anduril Industries... ...the expertise, technology, and business model of the 21st century's most innovative... ...questionable or fraudulent outreach claiming to be from Anduril, please report it immediately...ClaimsFull timeWork experience placementImmediate start$113k - $149k
...Operations Analyst, Software Spend This is a CIO Office role,... ...Finance, Procurement, and senior business stakeholders to drive... ...Anduril is changing how military systems are designed, built and sold.... ...questionable or fraudulent outreach claiming to be from Anduril, please...ClaimsFull timeWork experience placementWork at officeImmediate start$146k - $194k
...the expertise, technology, and business model of the 21st century's... ...Anduril is changing how military systems are designed, built and sold.... ...Receipt Accounting Systems Analyst with deep Oracle Cloud Fusion... ...or fraudulent outreach claiming to be from Anduril, please report...ClaimsFull timeContract workWork experience placementWork at officeImmediate start$166k - $220k
...bringing the expertise, technology, and business model of the 21st century's most innovative... ..., Anduril is changing how military systems are designed, built and sold. Anduril's... ...any questionable or fraudulent outreach claiming to be from Anduril, please report it immediately...ClaimsFull timeWork experience placementImmediate start$18 - $25 per hour
...about us: We are a large network of Medical Clinics in the Southern California Area. Why join... ...and payments, including insurance claim paperwork. Collaborate with medical and non... ...Proficient in medical terminology, healthcare systems, and patient scheduling software....Hourly payContract workLocal areaFlexible hoursAfternoon shift
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