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Claim Dispute Analyst Jobs (NOW HIRING)

EmblemHealth

Claims Review Analyst

New York, NY · On-site

Maintain and organize detailed information on claims dispute files to ensure appropriate and ... Strong knowledge of claim processing policies and procedures. * Knowledge of medical terminology ...

EmblemHealth

Claims Review Analyst

New York, NY · On-site

$48K - $83K/yr

Maintain and organize detailed information on claims dispute files to ensure appropriate and ... Strong knowledge of claim processing policies and procedures. * Knowledge of medical terminology ...

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How much do claim dispute analyst jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for claim dispute analyst in the United States is $27.91, according to ZipRecruiter salary data. Most workers in this role earn between $23.08 and $34.13 per hour, depending on experience, location, and employer.

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Claims Review Analyst

New York, NY • On-site

EmblemHealth
Insurance Services • 1 - 5K employees
Learn more about EmblemHealthexternal

Per diem

Medical

Re-posted 26 days ago

EmblemHealth rating

9.4

Company rating: 9.4 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

Summary of Position

  • Support contract performance management of a large health system.
     
  • Review and analyze suspected underpaid and overpaid claims from hospital, ancillary, and provider groups based on contractual and industry guidelines.
     
  • Identify and analyze single issues and trends to determine root causes.
     
  • Provide recommendations for solutions to minimize errors and delays in systems and/or processes.
     
  • Monitor system output to ensure proper functioning.


Roles and Responsibilities

  • Evaluate disputed claims for system configuration, claims processing, and/or contractual issues to facilitate claims review.
     
  • Maintain and organize detailed information on claims dispute files to ensure appropriate and comprehensive data is returned to the provider timely.
     
  • Track issues and monitor trends to support their resolution.
     
  • Identify potential/actual claims problems (single or recurring/trending) and document root cause analysis; present findings to management.
     
  • Improve quality, enhance workflow, and provide efficiencies within departments, identify opportunities for improvements; develop and present recommendations for changes.
     
  • Conduct regular meetings with the assigned provider groups for status of AR files and recycles
     
  • Support departmental goals for cycle time by organizing and tracking claims for review.
     
  • Monitor and provide timely responses for the designated provider group emails and AR files.
     
  • Perform other related tasks as directed or required.

Qualifications

  • Bachelor's Degree; additional experience/specialized training may be considered in lieu of educational requirements.
     
  • 2 - 3 years' prior related work experience in professional/facility claims or benefits/billing environment. 
     
  • Strong knowledge of claim processing policies and procedures.
     
  • Knowledge of medical terminology, ICD/CPT coding, per diem and DRG reimbursement and EDP testing procedures.
     
  • Proficiency with MS Office applications (word processing, database/spreadsheet, presentation).
     
  • Ability to accurately interpret information from contractual and technical perspectives.
     
  • Must be conscientious and detail oriented; ability to recognize unusual patterns and troubleshoot for operational improvement and efficiencies.
     
  • Strong analytical and problem-solving skills.
     
  • Ability to effectively work on multiple projects/tasks with competing priority levels and deadlines.
     
  • Ability to effectively absorb and communicate information.
     
  • Strong Interpersonal and teamwork skills.
Additional Information
  • Requisition ID: 2603P
  • Hiring Range: $48,600-$83,160

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