ZipRecruiter

Log In

1

Claims Repricer Jobs (NOW HIRING)

MedTrust LLC

Medical Claims Repricer

Oklahoma City, OK · On-site

Our Medical Claims Repricer/Analyst is responsible for reviewing and processing hospital and provider claims to ensure accuracy, completeness, and compliance with contracts and statutory terms. The ...

MedTrust LLC

Medical Claims Repricer

Oklahoma City, OK · On-site

Our Medical Claims Repricer/Analyst is responsible for reviewing and processing hospital and provider claims to ensure accuracy, completeness, and compliance with contracts and statutory terms. The ...

All JobsFinance And Insurance JobsInsurance JobsInsurance Claims Specialist JobsClaims Repricer Jobs

Claims Repricer information

See salary details

$12

$23

$43

How much do claims repricer jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for claims repricer in the United States is $23.50, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $25.72 per hour, depending on experience, location, and employer.

What is a claims repricer?

Claims repricers are professionals who review and adjust healthcare insurance claims to ensure that the charges align with contracted rates, fee schedules, or usual and customary pricing. They analyze medical billing codes, compare them to payer agreements, and apply cost containment measures to help insurance companies or third-party administrators control expenses. Claims repricers play a key role in the accuracy and fairness of claim payments while helping prevent overpayments or claim errors. Their work ensures both providers and payers adhere to agreed-upon rates, contributing to overall efficiency in the healthcare reimbursement process.

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

To thrive as a Claims Repricer, you need a solid understanding of healthcare billing, insurance terminology, and reimbursement methodologies, often supported by experience in medical claims processing or a related field. Familiarity with claims adjudication systems, pricing software, and knowledge of CPT, ICD-10, and HCPCS codes is typically required. Strong analytical thinking, attention to detail, and effective communication help ensure accuracy and resolve discrepancies. These skills are vital for ensuring claims are processed efficiently and accurately, minimizing errors and supporting fair reimbursement.

How does a claims repricer typically collaborate with other departments, such as billing or provider relations?

Claims Repricers often work closely with departments like billing and provider relations to ensure that medical claims are accurately priced according to contract terms and payer policies. Collaboration may involve discussing complex cases, clarifying contract language, or resolving discrepancies in claims data. Effective communication with these teams is essential to streamline workflows, minimize errors, and maintain positive provider relationships. This cross-departmental interaction helps Claims Repricers stay updated on policy changes and ensures that repricing decisions are consistent and compliant.

What is the difference between Claims Repricer vs Claims Adjuster?

AspectClaims RepricerClaims Adjuster
CredentialsTypically requires insurance knowledge, certifications like CPCU or AICRequires similar certifications, often with state licensing
Work EnvironmentMostly office-based, analyzing claims dataField and office-based, investigating claims
Industry UsageUsed by insurance companies to set claim payoutsHandles claim investigations and settlements

While both roles involve insurance claims, Claims Repricers focus on analyzing and adjusting claim amounts using data, whereas Claims Adjusters investigate claims and determine coverage. The roles often overlap in skills and certifications but differ in daily tasks and focus areas.

Is claims processing a stressful job?

Claims Repricers often work in a fast-paced environment where accuracy and attention to detail are essential. The job can be stressful during high-volume periods or when resolving complex claims, but proper training and organization can help manage workload and reduce stress levels.

What are popular job titles related to Claims Repricer jobs?

For Claims Repricer jobs, the most frequently searched job titles are:

Claims Repricer jobs near you
Infographic showing various Claims Repricer job openings in the United States as of September 2026, with employment types broken down into 1% Internship, 88% Full Time, 9% Part Time, and 2% Contract. Highlights an 82% Physical, 4% Hybrid, and 14% Remote job distribution, with an average salary of $48,885 per year, or $23.5 per hour.

Medical Claims Repricer

Oklahoma City, OK • On-site

MedTrust LLC
See more jobs at MedTrust LLCexternal

Full-time

Posted 7 days ago

Job description

Overview

Claims repricing is the process of reviewing and adjusting healthcare claims to ensure that the billed charges align with statutory and/or contracted rates between providers and payers. This process helps control costs by applying discounts, fee schedules, statutory limits or negotiated rates to the original charges before payment is made. Claims repricing professionals analyze claims data and ensure compliance with contractual and statutory requirements. The goal at MedHealth is to ensure the most favorable and accurate rates for taxpayers and prevent overpayment or underpayment for healthcare services.

Our Medical Claims Repricer/Analyst is responsible for reviewing and processing hospital and provider claims to ensure accuracy, completeness, and compliance with contracts and statutory terms. The role negotiates favorable rates where they don’t already exist and otherwise determines the most favorable appropriate reimbursement based on statutory, contract, and negotiated rates. The Medical Claims Repricer/Analyst also resolves discrepancies, communicates with healthcare providers, and follows healthcare regulations and billing procedures.

Role Summary

This role ensures medical claims are reviewed, repriced, resolved accurately and then timely approved for payment. The Medical Claims Repricer/Analyst compares billed charges against applicable statutory limits, contracted rates, custom fee schedules, discounts, and negotiated terms to identify the most favorable allowable reimbursement for county clients.

Job Duties

  • Reprice claims: Apply the most favorable applicable reimbursement using discounts, custom fee schedules, statutory limits (where applicable) and negotiated contract terms for MedHealth clients. When no negotiated rate exists, the Medical Claims Repricer/Analyst works with providers to negotiate the most favorable rates for MedHealth clients.


  • Analyze codes: Review CPT, ICD-10, and HCPCS codes to confirm services are categorized correctly and priced using the appropriate reimbursement.
  • Check errors: Identify and correct discrepancies in electronic or paper billing forms, including duplicate billing, patient information, incorrect codes, or other claim inaccuracies.
  • Resolve issues: Correct pricing or other billing errors through correcting, repricing, documenting the resolution, and notifying the billing entity when adjustments are completed and ready to be paid.
  • Track productivity: Monitor claim volume, processing timeliness, accuracy, appeal documentation, and approved-claim payment readiness.


  • Negotiate provider rates: Communicate with hospitals, physician offices, and other billing entities to obtain favorable rates, clarify billed charges, and support resolution of disputed claims.


  • Maintain compliance documentation: Record repricing decisions, supporting rate references, provider communications, and claim adjustments to support audit readiness and appeal review.


  • Accounting Teamwork. Communicate with others in the process cycle to ensure that all are accurately processed, reviewed and paid timely. Assist as needed in clarifying or expediting issues. 

Minimum Qualifications

  • Education: High school diploma required; college degree preferred.


  • Experience: 1 to 3 years of experience in medical billing, coding, repricing or insurance claims processing.


  • Skills: Strong knowledge of medical terminology, basic math, and computer programs such as Microsoft Excel. Familiarity with CPT, ICD-10, and HCPCS codes is essential for success in this role because Medical Claims Repricer/Analyst ensure the accurate and timely processing of claims.


  • Detail oriented: Maintain a high level of accuracy and efficiency to prevent payment errors and ensure claims are processed timely and correctly.


  • Communication: Comfortable speaking with hospitals and physician offices to negotiate aggressive favorable rates and assisting in resolving occasional appeals.


This position is based in the Oklahoma City corporate office, Monday through Friday, from 8:00 a.m. to 5pm



#IND