Mass Claims Adjustment Analyst

Insight Global

United States

On-site

USD 41,328 - 55,104

Full time

14 days+

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Benefits offered by this job

Medical insurance

Vision insurance

401(k)

Job summary

A large managed care organization is seeking an MCA Analyst for a contract-to-hire role. You will work within a claims adjustment team to ensure accurate adjustments after policy changes. Responsibilities include analyzing claims, validating data with SQL/Excel, and managing adjustment processes in Facets. Ideal candidates will have extensive claims processing expertise and experience with Facets. The position offers a base pay range of $30.00 to $40.00 per hour, alongside comprehensive benefits.

Qualifications

Expertise in end-to-end claims processing within Facets.
Experience with data validation and accuracy processes.
Ability to perform root-cause analysis for process improvement.

Responsibilities

Review and analyze large claim adjustment requests.
Validate data accuracy using SQL/Excel.
Run mass claim adjustments in Facets environments.
Manage adjustment inventory to meet SLAs.

Skills

SQL

Excel

Data Analysis

Claims Processing

Facets

Job description

About the Role

A large managed care organization is looking for a MCA Analyst for a contract‑to‑hire opportunity. The role sits within a specialized claims adjustment team that steps in after system or policy changes impact claims. The analyst will work with data, automation tools and Facets to ensure adjustments are accurate, efficient, and compliant. Responsibilities include reviewing and analyzing large claim adjustment requests and impact reports, using SQL/Excel to validate data for accuracy, running mass claim adjustments in Facets test and production environments, partnering with business stakeholders to obtain necessary approvals, and providing follow‑up monitoring and reconciliation after adjustments. Additional duties include tracking and managing adjustment inventory to ensure work is completed within SLAs and identifying root‑cause analysis to improve processes and drive efficiencies. Ideal candidates should have end‑to‑end claims processing expertise within Facets and, ideally, experience with the configuration/back‑end of Facets.

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Compensation

Base pay range: $30.00/hr – $40.00/hr

Employment Details