Remote Senior Claims Research Analyst - Medicaid

Molina Healthcare, Inc.; United States; Remote; USD 41,000 - 89,000; Full time

Job summary

Molina Healthcare is seeking a Senior Analyst, Claims Research (Medicaid Claims) for a fully remote role in the United States. The position emphasizes research on Medicaid claims, advanced Excel usage, and deep root-cause analysis to improve claim accuracy and regulatory compliance.

The candidate will lead complex claims projects, provide senior-level support, and collaborate across departments to remediate processing issues and reduce rework.

Qualifications

• Experience with medical claims processing and research in Medicaid and other programs.
• Advanced Excel skills and data analysis capabilities.
• Familiarity with regulatory and contractual claims requirements.
• Ability to perform root-cause analysis and implement remediation plans.
• Experience presenting complex analyses to senior stakeholders.

Responsibilities

• Lead complex claims research projects initiated by provider inquiries or audits.
• Perform root-cause analysis to identify systemic processing errors.
• Develop remediation strategies and track timely project execution.
• Provide in-depth analysis to leadership and cross-functional teams.
• Tailor reports and communicate findings to diverse audiences.

Skills

Medicaid claims

Advanced Excel

Root-cause analysis

Claims research

Regulatory knowledge

Data analysis

Tools

QNXT

Job description

Molina Healthcare is seeking a Senior Analyst, Claims Research (Medicaid Claims) for a fully remote role in the United States. The position emphasizes research on Medicaid claims, advanced Excel usage, and deep root-cause analysis to improve claim accuracy and regulatory compliance.

The candidate will lead complex claims projects, provide senior-level support, and collaborate across departments to remediate processing issues and reduce rework.