Claims Analyst

Join a USA Today Top 100 Workplace & Best in KLAS Team

Claims Analyst- Hybrid Baldwin Park

Pay Range: $20.00- $22.00 per hour| Schedule: Monday-Friday 8:00 AM- 4:30 PM | Location: Orlando, FL

About RSi:

RSi is a leading Revenue Cycle Management company serving healthcare organizations nationwide. We are committed to innovation, customer service excellence, and developing future leaders. Our culture values diversity, teamwork, and a tech-forward approach.

Position Summary:

Join our dynamic Medicaid Enrollment Department as a Claims Analyst. In this hybrid role, you'll work both remotely and in-office (three days per week), supporting Medicaid enrollment and retro authorization processes. You'll collaborate with internal teams and external partners to ensure timely and accurate authorization, with opportunities to expand into Enrollment Specialist duties as needed.

Key Accountabilities:

• Process retro authorization requests for Medicaid, ensuring compliance with state and federal guidelines
• Collaborate with hospital personnel, clients, and payers to verify eligibility and secure authorizations
• Respond promptly to daily inquiries and resolve issues related to Medicaid enrollment and authorizations
• Maintain effective workflow and support organizational standards, policies, and procedures
• Foster a positive, customer-focused work culture
• Support enrollment activities, including application review, eligibility verification, and documentation
• Perform other duties as assigned, including Enrollment Specialist tasks when required

Skills/Abilities/Experience & Qualifications:

• High School Diploma or equivalent
• Authorized to work in the United States; able to pass a background check
• Exceptional customer service and communication skills
• Strong problem-solving and case management abilities
• Proficiency with technology (Microsoft Word, Excel, Outlook, phone systems, etc.)
• Ability to work independently and collaboratively in a hybrid environment

Preference will be given to candidates with additional skills such as:

• Experience with Medicaid, Medicare, TPL, and commercial insurance recovery
• Understanding of HIPAA and HITECH patient confidentiality laws
• Familiarity with hospital systems and healthcare environments
• Prior experience in enrollment or authorization roles

Competitive Compensation Package:

• Competitive salary
• Medical, dental, and vision insurance
• Company-paid life insurance
• Paid volunteer time off
• Free wellness memberships
• 401K retirement plan
• Paid training and mentoring
• Opportunities for advancement

Physical Demands/Working Conditions:

Work will be primarily performed remotely. Candidates must have a stable dedicated workspace and secure internet connectivity. Computer equipment will be provided by the Company. Requires prolonged sitting, standing, or walking. Requires on-camera interactions with colleagues, leadership, and occasionally, clients. Consequently, appropriate work attire and professional setting is required. Requires eye-hand coordination and manual dexterity enough to operate a computer keyboard, photocopier, telephone, calculator, and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports. Requires lifting papers or boxes up to 15 pounds occasionally. Work may be stressful at times. Must be an effective communicator with strong problem resolution abilities.

OSHA Category:

The candidate selected for this position will not be required to conduct any medical care. Claims Analysts must abide by client-required policies such as wearing masks, providing COVID-19 vaccination status and testing, in the event that any on-site visits occur.