Cost-Containment Analyst, Healthcare Community Health System - 3.7 Fresno, CA Job Details Full-time $26.25 - $33.40 an hour 3 hours ago Benefits Free parking 403(b) matching Tuition reimbursement Qualifications Contract documentation review Contract review Legal analysis Contract interpretation Health insurance knowledge

Full Job Description Overview:

Opportunities for you! Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek Free Continuing Education and certification Tuition reimbursement, education programs and scholarships Vacation time starts building on Day 1, and builds with your seniority Free money toward retirement with a 403(b) and matching contributions Great food options with on-demand ordering Free parking and electric charging Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page.

Responsibilities:

The Cost-Containment Analyst is responsible for identifying, investigating, and resolving post-payment and pre-payment claim recovery opportunities while ensuring accurate claims administration and compliance with health plan policies, provider contracts, and applicable regulations. This position performs complex claim adjustments, manages provider payment disputes, processes claim payment refunds, coordinates subrogation and recovery activities, and analyzes claim payment trends to minimize financial risk and improve operational performance. The analyst collaborates with Claims Operations, Provider Relations, Finance, Legal, Compliance, and external stakeholders to ensure timely resolution of payment discrepancies and maximize cost recovery for the health plan.

Qualifications:

Education High School Diploma, High School Equivalency (HSE), or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required Associate's or Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, Health Information Management, or a related field preferred Experience Three (3) or more years of experience in health plan claims, payment integrity, cost containment, provider disputes, recovery, subrogation, or claims auditing, required Experience with provider contract interpretation and reimbursement analysis required Experience with health plan claims systems, particularly QNXT, preferred Advanced Microsoft Excel skills and experience with reporting or business intelligence tools are preferred

Disclaimers:

Pay ranges listed are an estimate and subject to change. If any bonuses are noted, they are only applicable to external hires meeting criteria.