Hill Physicians Medical Group · 3 hours ago
Lead, Analyst - 26-12
San Ramon, California
Full-time
Onsite
Mid, Senior Level
$30/hr - $33/hr
3+ years expHill Physicians Medical Group is shaping the healthcare of the future through actively managed care. The Lead Analyst will assist in achieving departmental goals by providing technical leadership, conducting thorough research on claims, and collaborating with internal teams to enhance operational performance.
Health CareMedicalProfessional Services
Responsibilities
Conduct thorough research on complex claim cases and issues, effectively communicating findings to both external partners and internal stakeholders
Identify, analyze, and interpret departmental trends to support informed strategic decision-making, including recognizing billing patterns, processing errors, and system issues that inhibit the final adjudication of claims
Manage urgent claim concerns by performing detailed investigations, delivering prompt and appropriate responses, and ensuring timely and accurate resolution
Perform in-depth research to address service, operational, and administrative challenges, enhancing performance and fostering continuous improvement
Collaborate closely with internal teams to set priorities and better align operations with both organizational and departmental objectives
Offer technical support to the Supervisor and staff to achieve the department’s objectives and expectations
Provide constructive feedback on operational performance, delivering prompt and actionable guidance to boost productivity and overall outcomes
Maintain accurate unit reports, proactively seek clarification when needed, and take decisive action as appropriate
Remain up-to-date with unit procedures, management technologies, and tools, consistently meeting departmental performance standards and expectations
Consult with external partners and internal parties as needed to facilitate effective communication and resolution of issues
Delegate tasks to team members, ensuring responsibilities are clearly communicated, and provide training while promptly addressing any questions from team members or the Supervisor as needed
Ensure that departmental policies, procedures, and practices consistently adhere to organizational standards, maintaining compliance across all operations
Facilitate Huddle meetings to recognize accomplishments, discuss key operational challenges, communicate ongoing initiatives, and promote open dialogue by actively encouraging information sharing, questions, and constructive feedback
Qualification
Required
High School diploma/GED required
Minimum of 3-5 years of claims processing experience required
Must possess the technical skills of the department (such as positions that are junior to the lead analyst position- claims processing, adjustments, auditing)
Minimum of three years' managed-care operations experience in an IPA like environment
Working knowledge of DMHC, CMS and Health Plan requirements
Proficient in Microsoft Word and Excel
Excellent leadership, organizational, and communication skills (oral/written)
Self-motivated, able to work independently
Results oriented
Company
Hill Physicians Medical Group
Hill Physicians Medical Group is an independent physician association that focuses on providing innovative and quality healthcare.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
David Joyner
Chief Executive Officer
Recent News
2025-11-05
2025-09-12
Seattle TechFlash
2025-04-17
Company data provided by crunchbase