Claims processor

Randstad is seeking a Claims Compliance Analyst. POSITION SUMMARY Maintains positive working relationships with our internal and external customers, health plan's, providers and/or members by seeking a partnership approach that will meet the company goals and vision. The Claims Compliance Analyst will coordinate Health Plan's audits activities with preparation and provide preliminary results on non-compliant claims to the Claims Director. Assists with an audit control checklist for prevention of claims untimeliness of payment. Collaborates in conjunction with the Managed Care Management Team and other auditors, to ensure QA programs are aligned with claims operations and other areas that have direct impact with claims to prevent non-compliance. Adheres to internal department standard operating procedures and applies standard industry guidelines in accordance with regulatory agencies (state and federal). Prepares and submits all monthly, quarterly and as needed reporting to the health plans (Monthly Timeliness, ODAGs, Part C, claims universe, etc.) salary: $30.38 - $30.39 per hour shift: First work hours: 7 AM - 3:30 PM education: High School Responsibilities Maintains positive working relationships with our internal and external customers, health plan's, providers and/or members by seeking a partnership approach that will meet the company goals and vision. The Claims Compliance Analyst will coordinate Health Plan's audits activities with preparation and provide preliminary results on non-compliant claims to the Claims Director. Assists with an audit control checklist for prevention of claims untimeliness of payment. Collaborates in conjunction with the Managed Care Management Team and other auditors, to ensure QA programs are aligned with claims operations and other areas that have direct impact with claims to prevent non-compliance. Adheres to internal department standard operating procedures and applies standard industry guidelines in accordance with regulatory agencies (state and federal). Skills Processor Claims Processing Claims Qualifications Years of experience: 2 years Experience level: Experienced Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact . Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility). This posting is open for thirty (30) days. Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.

Created: 2026-03-04