Lead Appeals Analyst

Join the Covered California team!

Are you a skilled problem-solver with a passion for navigating complex issues and delivering clear, actionable solutions? Covered California is looking for a Lead Appeals Analyst to join our Consumer Relations and Resolution team, where your expertise in resolving customer appeals, escalations, and administrative processes will make a real impact. This role offers the opportunity to leverage your experience in the insurance or healthcare industry, your knowledge of the Affordable Care Act, your talent and experience in researching customer issues, preparing well-crafted statements and recommendations, and your expertise in implementing effective resolution for identified issues. If you thrive in customer-facing environments, are familiar with using Customer Relationship Management (CRM) systems like Salesforce to maintain customer information, and are proficient with Microsoft Office applications, this position is your opportunity to excel while contributing to meaningful outcomes!

At Covered California, we recognize our employees are our most valuable asset. We have a variety of career fields that help make a difference in the lives of Californians, and we’re looking for talented and enthusiastic individuals to join our team! Learn more about why you should join the Service Center Division.

Salary: $6,031.00 - $7,775.00 per Month

Application Deadline: 08/06/2026 @ 11:59 pm PST

Required Documents: Application, Resume and Statement of Qualifications (SOQ)

Qualifications We’re Looking For:

• 2 years of experience in the insurance/healthcare industry working on customer appeals, escalations and/or complaints, conducting research and analysis of complex issues, and resolution coordination
• 2 years of experience interpreting State and Federal laws, Regulations and/or policies
• 1 year of experience working with ACA-related policies, programs, or initiatives.
• 2 years of experience presenting information verbally and in writing, preparing written statements of position, recommendations, reports and/or findings in a professional setting
• 2 years of experience in customer service or call center and familiarity with Customer Relationship Management systems like Salesforce or similar platforms.
• 2 years of experience using Microsoft Office Suite and Adobe Acrobat Professional to prepare reports, compile and analyze data, prepare presentations, and collaborate across teams using Teams, Webex or other communication platforms.

Minimum Qualifications:

Analyst II - CalHR Public Portal

Employee Benefits:

Covered California provides incredible benefits for our employees, including healthcare, retirement and savings, work-life services, leave benefits, and work-life balance. To learn more, visit https://hbex.coveredca.com/careers/benefits/.

Note:

• To apply to this position, review this advertisement and complete your application via CalCareers at: CalCareers
• Please send any questions regarding the application process and/or position to Careers@covered.ca.gov
• New to state civil service employees are typically hired at the minimum of the salary range