Community Health System

Cost-Containment Analyst, Healthcare

Community Health System  •  Fresno, CA (Onsite)  •  1 hour ago
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Job Description

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.

Community Health System

About Community Health System

Community Health System is a private, not-for-profit, health system that employs more than 11,000 people. We've grown a lot since 1897 and we're not done yet.

We have affiliations of nearly 2,500 physicians, a partnership with UCSF Fresno, and one of central California's largest HMO health plans. Being a part of the Community family means being a part of the innovation that cares for more residents in the Central Valley than any other healthcare system in the area. And we do it for everybody, regardless of their ability to pay.

​​​​​​​If you want to be a part of a team that operates like a family and challenges each other to constantly improve and grow together, you belong here.

Industry
Healthcare & Social Services
Company Size
1,001-5,000 employees
Headquarters
Fresno, CA
Year Founded
Unknown
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