Senior Claims Operations & Data Analyst (Remote CA)

ADP, Inc.

French Camp (CA)

Remote

USD 97,000 - 140,000

Full time

2 days ago

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Benefits offered by this job

Medical coverage

Dental & vision

PTO & holidays

CalPERS retirement

FSAs

Life & AD&D Insurance

Remote work

Job summary

ADP, Inc. is seeking a Senior Claims Operations & Data Analyst to lead advanced analytics, workflow redesign, and system logic for claims operations. This role blends data analysis with operational optimization, serving as a senior expert across QA, recovery, PDR, and auto-adjust processes.

The position supports transformation initiatives, designs routing logic, and produces executive-level materials. Remote work is allowed within California service areas; extensive collaboration with leadership

Qualifications

In-depth knowledge of claims operations, routing and pend logic, adjustments, PDR, QA, recovery, and auto-adjust workflows.
Intermediate SQL skills and advanced Excel capabilities.
Ability to design workflows using Visio/Lucidchart.

Responsibilities

Perform end-to-end assessments of Claims Operations workflows including processing, adjustments, PDR, QA, recovery, pend logic, routing, and auto-adjust logic.
Redesign workflows, routing rules, and logic models to improve accuracy, efficiency, and first-pass outcomes.
Develop and update business rules and system logic alignment with QNXT, Jiva, Symplr Payor, and related systems.
Run complex SQL queries to analyze claims data and build dashboards for leadership.
Prepare operational diagnostics and executive-level materials for Directors and Executives.