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Claims Process Analyst Jobs (NOW HIRING)

KARNA LLC

$22 - $25/hr

Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance. * Critical Analysis: Analyze claims and adjudicate them ...

KARNA LLC

$20 - $25/hr

Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance. * Critical Analysis: Analyze claims and adjudicate them ...

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY

$18.75 - $23.75/hr

Process and evaluate hospital claims manually or through claims work flow * Validate information ... Demonstrated organizational, perform multiple priorities, and analytical skills with the ability to ...

Searhc

Medical Claims Analyst

Juneau, AK

$31.83 - $44.56/hr

This role performs claims review and processing, eligibility verification, referral validation ... Research, problem solving, claims analysis, and issue resolution. * Using claims processing systems ...

TEKsystems

Mechanical Claims Analyst

Earth City, MO · On-site +1

$26 - $36/hr

Review, investigate, and process mechanical warranty claims accurately and efficiently. * Utilize automotive repair knowledge to determine warranty coverage based on established guidelines.

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY

$18.75 - $23.75/hr

Process and evaluate hospital claims manually or through claims work flow * Validate information ... Demonstrated organizational, perform multiple priorities, and analytical skills with the ability to ...

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY

$18.75 - $23.75/hr

... claims Process and evaluate hospital claims manually or through claims work flow Validate ... and analytical skills with the ability to follow through on assignments Able to work well ...

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Claims Process Analyst information

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How much do claims process analyst jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for claims process 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.

How does a claims process analyst typically collaborate with other departments to resolve complex claims issues?

Claims Process Analysts frequently work cross-functionally, engaging with teams such as underwriting, customer service, and legal to resolve complex or disputed claims. This collaboration often involves gathering additional documentation, clarifying policy details, and ensuring compliance with regulations. Effective communication and problem-solving skills are essential, as analysts act as the liaison between internal teams and sometimes external stakeholders to facilitate timely and accurate claim resolutions.

What does a claims process analyst do?

A Claims Process Analyst is responsible for reviewing, analyzing, and processing insurance claims to ensure they are accurate and comply with company policies and regulations. They investigate claim details, verify documentation, and work with other departments to resolve discrepancies or issues. Their role often involves identifying trends in claims data, recommending process improvements, and ensuring timely resolution of claims to provide a positive customer experience.

How much do claims process analysts make in the US?

Claims process analysts in the US typically earn a median annual salary of around $50,000 to $70,000, depending on experience, location, and industry. Entry-level roles may start lower, while experienced analysts or those with specialized skills can earn higher salaries, often supplemented with benefits and opportunities for advancement.

What is the difference between Claims Process Analyst vs Claims Adjuster?

AspectClaims Process AnalystClaims Adjuster
CredentialsTypically requires a bachelor's degree in business, insurance, or related field; certifications like CPCU or ARM are commonRequires a high school diploma or equivalent; certifications such as AIC or CPCU are advantageous
Work EnvironmentOffice-based, analyzing claims data, process improvement, and policy reviewField or office-based, investigating claims, inspecting damages, and negotiating settlements
Employer & IndustryInsurance companies, third-party administrators, and corporate claims departmentsInsurance companies, adjusting firms, and independent agencies

While both roles work within the insurance industry, Claims Process Analysts focus on analyzing and improving claims processes, whereas Claims Adjusters handle the investigation and settlement of individual claims. Understanding these differences helps job seekers identify the right career path based on their skills and interests.

Is being a claims process analyst hard?

Being a claims process analyst involves reviewing insurance claims, analyzing data, and ensuring accuracy, which requires attention to detail and strong organizational skills. The role can be challenging due to the need to interpret policies, handle complex cases, and meet deadlines, but it is manageable with proper training and experience in claims processing systems. Familiarity with industry regulations and certifications can also aid in performing the job effectively.

What are the key skills and qualifications needed to thrive as a claims process analyst?

To excel as a Claims Process Analyst, you need strong analytical skills, attention to detail, and a background in insurance or finance, often supported by a relevant degree. Familiarity with claims management software, data analysis tools, and regulatory compliance systems is typically required. Excellent problem-solving, communication, and organizational skills help distinguish top performers in this role. These abilities ensure accurate claims assessment, efficient processing, and regulatory compliance, which are vital to maintaining customer trust and minimizing organizational risk.
More about Claims Process Analyst jobs
What states have the most Claims Process Analyst jobs? States with the most job openings for Claims Process Analyst jobs include:
What job categories do people searching Claims Process Analyst jobs look for? The top searched job categories for Claims Process Analyst jobs are:
Claims Process Analyst jobs near you
Infographic showing various Claims Process Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 16% Part Time, 4% Contract, and 1% Nights. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $56,974 per year, or $27.4 per hour.

Experienced Healthcare Claims Processor

KARNA LLC

On-site, Remote

$22 - $25/hr

Full-time

Re-posted 11 days ago

Job description

Job Type
Full-time
Description
Join the new Bakinaw-Karna Joint Venture Team as a Temporary, Full-Time Medical Claims Processor. Become an integral part of a team dedicated to servicing the World Trade Center Health Program. In this role, you will leverage your meticulous attention to detail and commitment to accuracy in processing complex medical claims. If you're eager to make a positive impact in our community through your administrative skills, we encourage you to apply!
The Saginaw Chippewa Indian Tribe of Michigan, in accordance with the spirit of PL. 93-638, adopted January 4, 1975, will provide preference to Native Americans meeting minimum position qualifications who have equal qualifications for the position(s) to those of other applicants.
*Minimum of 5 years' experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims* Candidates must be located in one of the following states: FL, GA MD, MI, TX
Job Responsibilities:
  • Claims Review and Processing: Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance.
  • Critical Analysis: Analyze claims and adjudicate them according to program guidelines, employing critical thinking to navigate complex scenarios.
  • Timely Processing: Ensure claims are processed promptly to meet client standards and regulatory requirements, employing effective problem-solving skills to address any barriers.
  • Issue Resolution: Proactively resolve claim discrepancies and issues by collaborating with other departments, utilizing analytical skills to identify root causes and implement solutions.
  • Confidentiality Maintenance: Uphold the confidentiality of patient records and company information as per HIPAA regulations.
  • Detailed Record Keeping: Maintain thorough records of claims processed, denied, or requiring further investigation, ensuring transparency and traceability.
  • Trend Monitoring: Analyze and report on trends in claim issues or irregularities to management, contributing to process improvement initiatives; Assists Team Leads with reporting.
  • Audit Participation: Engage in audits and compliance reviews to ensure adherence to internal and external regulations, using critical thinking to evaluate processes.
  • Mentoring: Mentors and trains new claims processors as needed.

Requirements
  • High school diploma or equivalent.
  • Minimum of 5 years' experience in processing medical professional and facility claims as well as complex and high-dollar claims.
  • Familiarity with ICD-10, CPT, and HCPCS coding systems.
  • Must have experience working with modifiers and bill types.
  • Understanding of medical terminology, healthcare services, and insurance procedures (worker's compensation experience is a plus).
  • Strong attention to detail and accuracy.
  • Ability to interpret and apply insurance program policies and government regulations effectively.
  • Excellent written and verbal communication skills.
  • Proficient in Microsoft Office Suite (Word, Excel, Outlook).
  • Capacity to work independently as well as collaboratively within a team.
  • Commitment to ongoing education and training in industry standards and technology advancements.
  • Experience with claim denial resolution and the appeals process.
  • Ability to efficiently manage a high volume of claims.
  • Customer service-oriented with strong problem-solving capabilities.
  • Must be flexible and have the ability to adjust to the needs of the client and changes in the program.

PM18
#remote
Salary Description
$22-25/hour

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