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At Fortuna, we are committed to fostering a diverse and inclusive workplace where every employee, including veterans, can thrive. Become part of a team where your talents are valued and your achievements are celebrated.
Take the next step in your professional journey with us!
We are seeking a detail-oriented and motivated Healthcare Claims Analyst to join our team. In this role, you will be responsible for reconciling healthcare payments, posting claims, generating invoices, and analyzing errors to ensure accuracy in financial and claims processing. This is an exciting opportunity for someone with healthcare claims experience to work in a fully remote environment, contribute to process improvements, and support business operations that directly impact patient care and reimbursement.
WORKSITE: Remote
WORK SCHEDULE: Monday – Friday, standard business hours
PAY RATE: $19.00 per hour
JOB POSTING TITLE: Associate Professional Business Analyst
WHAT WE OFFER
Paid sick leave based on state regulations after 90 days of employment
Medical, dental, and vision coverage after a waiting period (60% paid by Fortuna)
Free TeleMedicine and Mental Health support for all employees and their families
Additional voluntary benefits: Group Life Insurance, Accidental Insurance, Critical Care, Short-Term Disability
Professional development and advancement opportunities
WHAT YOU'LL DO
Post payments to medical and pharmacy claims from paper and electronic EOBs daily.
Reconcile AR and correct discrepancies or posting issues.
Identify, analyze, and resolve errors in claim postings and payments.
Participate in client meetings to gather and document requirements and explore solutions.
Assist in analyzing and documenting client business requirements and processes.
Develop and modify systems requirements documentation to meet client needs.
Generate and distribute monthly invoices using PeopleSoft Finance based on claims posted.
Create, run, and deliver posting and reconciliation reports; analyze trends and anomalies.
Use FTP protocols to securely transfer files from various sources.
Maintain accurate documentation for audit and compliance purposes.
Collaborate across departments to resolve issues related to claims and payments.
Work independently in a remote environment while meeting deadlines and SLAs.
WHAT YOU'LL BRING
Bachelor's degree in Business, Healthcare Administration, Finance, or related field; OR 3–5 years of medical claims posting/reconciliation experience.
Solid understanding of medical and pharmacy claims adjudication and Medicaid reclamation claims.
Proficiency in SQL for data extraction and analysis.
Familiarity with PeopleSoft Finance or similar enterprise financial systems.
Strong problem-solving and troubleshooting skills with the ability to work independently.
Experience with FTP protocols and secure file transfer.
Excellent written and verbal communication skills.
Strong attention to detail and organizational skills.
PREFERRED QUALIFICATIONS
Experience with healthcare data analytics or reporting tools.
Prior experience in a remote or hybrid work environment.
Knowledge of healthcare payment cycles and insurance reimbursement processes.
ABOUT FORTUNA
Fortuna operates as a staffing agency that sources, screens, and presents potential candidates for employment opportunities on behalf of our clients. Founded in 2012 by practicing professionals with more than 50 years of combined experience, our headquarters is in McClellan, California, with offices in Los Angeles and New York, and satellite offices in the Philippines and Israel.
Fortuna is an active member of multiple California service agreements, including CMAS, ITMSA (Tier 2), and CalPERS SpringFed Pool, as well as multiple municipalities and large corporation vendor pools.
Career Site: www.gofortuna.com
Why Choose Us?
- Collaborate with local community organizations, job placement agencies, and educational institutions to reach a broader pool of candidates.
- Actively participate in career fairs and job expos to connect with potential employees from diverse backgrounds.
- Establish a wide range of job positions across various departments to accommodate individuals from diverse backgrounds, including veterans, civilians, and those with unique skill sets. This approach ensures that everyone has the opportunity to find a role that aligns with their abilities and interests.
- Pair new hires, including veterans and civilians, with experienced mentors who can provide guidance, support, and insights during their transition into the organization. This mentorship fosters a sense of belonging and helps individuals navigate workplace dynamics.
- Identify skill gaps and provide training programs to help you acquire the necessary qualifications for their desired roles.
- Foster a workplace culture that actively recognizes and appreciates the unique experiences and contributions of all employees, including veterans.
Provide competitive salary and benefits packages that cater to the needs of all employees, including veterans. This should encompass:
- Health Insurance: Offer comprehensive health insurance plans that cover medical, dental, and vision care.
- Paid Time Off: Ensure generous paid time off policies that allow employees to recharge and attend to personal commitments.
- Implement a preferential hiring policy for veterans, giving them a competitive advantage during the application process.
- Offer guidance on translating military skills and experience into civilian job qualifications.
- Recognize outstanding veteran employees through awards and appreciation events.
- Highlight veteran success stories within the organization to inspire others.
Maximizing solutions through collaboration and partnerships.
- Certifications
