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Claim Editing Analyst Jobs (NOW HIRING)

Vytwo

Senior Data Analyst Claims Reconciliation

Prosper, TX · Remote

$88K - $111K/yr

Analyze claim changes occurring throughout the processing lifecycle, including edits, benefit ... Claims editing * Prior authorization matching * Documentation or medical-record requests * Contract ...

Capital Health Plan

Claims Examiner I

Tallahassee, FL · On-site

Ability to read, understand, and interpret claim editing documentation and healthcare regulatory ... As a Claims Examiner I, you will analyze insurance claims of low to moderate difficulty to ...

Careoregon

Payment Integrity Analyst

OR · On-site +1

Review vendor overpayment suggestions for accuracy, adherence to scope, claim recovery activities ... Knowledge and skill in using claims management systems, editing software and medical coding Skills ...

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Claim Editing Analyst information

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How much do claim editing analyst jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for claim editing analyst in the United States is $27.39, according to ZipRecruiter salary data. Most workers in this role earn between $20.19 and $31.49 per hour, depending on experience, location, and employer.

What is a claim editing analyst?

Claim Editing Analysts are professionals who review and analyze medical or insurance claims to ensure accuracy, compliance with regulations, and adherence to payer policies. They identify coding errors, inconsistencies, or potential fraud within submitted claims, often using specialized software tools called claim editors. Their work helps reduce claim denials, prevent overpayments, and streamline the reimbursement process for healthcare providers and insurance companies. Claim Editing Analysts may also provide feedback and education to billing staff to improve future claim submissions.

What skills and qualifications are needed to be a claim editing analyst?

To thrive as a Claim Editing Analyst, you need strong analytical skills, attention to detail, and a solid understanding of medical billing and coding, typically supported by a degree in healthcare administration or a related field. Familiarity with claim editing software, healthcare information systems, and coding certifications such as CPC or CCS is often required. Excellent problem-solving abilities, communication skills, and the capacity to work independently make someone stand out in this position. These skills ensure accurate claim processing, compliance with regulations, and minimized billing errors, all of which are crucial for efficient healthcare operations.

How does a claim editing analyst collaborate with other departments to resolve complex claims issues?

A Claim Editing Analyst often works closely with teams such as claims processing, IT, compliance, and provider relations to investigate and resolve claim discrepancies. Collaboration involves sharing insights on claim rejections, discussing potential system edits, and recommending workflow improvements. Regular meetings and cross-functional communication are common to ensure claims are processed accurately and efficiently, reducing the risk of errors and ensuring compliance with industry regulations.

What are popular job titles related to Claim Editing Analyst jobs?

For Claim Editing Analyst jobs, the most frequently searched job titles are:

Infographic showing various Claim Editing Analyst job openings in the United States as of June 2026, with employment types broken down into 69% Full Time, 27% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $56,974 per year, or $27.4 per hour.

Analyst Senior - Payment Integrity Prospective Editing

Detroit, MI • On-site

Blue Cross Blue Shield of Michigan
Insurance Services • 5 - 10K employees
Learn more about Blue Cross Blue Shield of Michiganexternal

Full-time

This job post has expired today. Applications are no longer accepted.

Blue Cross Blue Shield of Michigan rating

7.8

Company rating: 7.8 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

Job description

Responsible for leading the development and implementation of programs and strategies by identifying insights that enhance business decision making capability. This includes developing or changing workflows and implementing process improvements to enhance organizational products, programs and service to our customers.

  • Identify and analyze operational data and develop insights in support of business objectives.
  • Develop and improve work flows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality.
  • Identify and/or analyze business problems and develop recommendations for solutions to problems.
  • Lead the development and implementation of projects and/or teams in order to produce desired results.
  • Document and communicate project concepts, milestones and results.
  • Recommend and assist with implementing standard policies and procedures.
  • Ensure that corporate compliance is communicated, implemented and monitored on an ongoing basis.
  • Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
  • Provide support to internal departments and external entities by answering questions, supplying information and training.
  • Create and present reports and presentations to display operational data and proposed business changes.

"Qualifications"

  • Bachelor's Degree in a related field is preferred.
  • Four (4) years of experience in a related field is required.
  • Excellent analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.
  • Organizational skills and ability to prioritize; must be able to lead multiple activities with varying timelines.
  • Excellent verbal, written communication and interpersonal skills.
  • Ability to lead and contribute to business unit and/or corporate projects.
  • Proficient in Microsoft Office Suites.

  • Ability to develop and maintain effective working relationships.

Departmental Preferences:

  • Ability to analyze medical claim data to identify opportunities for claim edits preferred.
  • Broad understanding of BCBSM PPO/BCN reimbursement, medical and payment policies is preferred.
  • Ability to apply advanced data analytic techniques and root cause analysis is preferred.
  • Intermediate skill using Microsoft applications including Excel, Word and PowerPoint is preferred.

  • Expert level experience with NASCO claims system preferred.

All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.

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