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Claims Research Analyst Jobs (NOW HIRING)

Ourhrconnect

Claims Research Analyst

Carolina, RI · On-site +1

... claims software systems. * Knowledge of medical terminology, CPT IV coding, ICD 9 diagnosis codes, or NCPDP coding as appropriate. * Good analytical skills and the ability to retrieve and research ...

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Molina Healthcare

Analyst, Claims Research

Long Beach, CA · On-site +1

$19.84 - $38.69/hr

Job Summary Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of ...

Molina Healthcare

Analyst, Claims Research

Long Beach, CA · On-site

$19.84 - $38.69/hr

Job Summary Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of ...

WebTPA

Claims Examiner I

San Antonio, TX · Remote

This will include claims research where applicable and a range of claim complexity. What Will You ... to analyze. - Ability to learn quickly and multitask. - Proficiency in maintaining good rapport ...

Guidewell

Claims Examiner I

San Antonio, TX · On-site

This will include claims research where applicable and a range of claim complexity. What Will You ... Must possess proven judgment, decision-making skills and the ability to analyze. * Ability to learn ...

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How much do claims research analyst jobs pay per hour?

As of Jun 17, 2026, the average hourly pay for claims research 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 much do claims analysts make in the US?

Claims research analysts in the US typically earn an average salary of around $50,000 to $70,000 per year, depending on experience, location, and industry. Entry-level positions may start lower, while experienced analysts or those with specialized skills can earn higher salaries. Compensation often includes benefits such as health insurance and retirement plans.

What is a claims research analyst job description?

A claims research analyst reviews insurance claims to verify accuracy, identify discrepancies, and determine claim validity. They analyze data, gather supporting documentation, and use claims management software to ensure proper processing and prevent fraud. Strong attention to detail and knowledge of insurance policies are essential for this role.

What does a Claims Research Analyst do?

A Claims Research Analyst reviews, investigates, and analyzes insurance claims to determine their validity and accuracy. They gather and assess relevant documentation, such as policy information and supporting evidence, to ensure claims are processed correctly and in compliance with regulations. Analysts also communicate with claimants, providers, and other stakeholders to clarify information and resolve discrepancies. Their primary goal is to identify errors, prevent fraud, and help ensure fair claim settlements.

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

AspectClaims Research AnalystClaims Adjuster
Primary RoleResearches and analyzes insurance claims data to identify trends and support decision-makingEvaluates and settles insurance claims by investigating damages and determining coverage
Required SkillsData analysis, research, attention to detailInvestigation, negotiation, customer service
Work EnvironmentOffice-based, research-focusedField and office-based, claims investigation
CertificationsTypically none required, but industry certifications can helpAdjuster licenses often required

While both roles work within the insurance industry, Claims Research Analysts focus on data analysis and research to support 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.

What does a claims analyst do?

A claims research analyst reviews insurance claims to verify their accuracy, determine coverage, and assess liability. They analyze data, interpret policy details, and may use specialized software to ensure claims are processed correctly and efficiently.

What jobs pay 2000 a day?

Claims Research Analysts typically do not earn $2,000 a day; such high daily earnings are more common in specialized fields like high-level consulting, investment banking, or certain executive roles. These positions often require extensive experience, advanced skills, and certifications, and may involve variable compensation structures including bonuses or commissions.

What are the key skills and qualifications needed to thrive as a Claims Research Analyst, and why are they important?

To succeed as a Claims Research Analyst, you need strong analytical abilities, attention to detail, and a background in finance, insurance, or a related field, often supported by a bachelor’s degree. Familiarity with claims management systems, data analysis tools like Excel or SQL, and knowledge of regulatory compliance are frequently required. Excellent problem-solving skills, effective communication, and the ability to manage time efficiently will set candidates apart. These competencies are crucial for accurately investigating claims, ensuring compliance, and maintaining organizational integrity.

What are some common challenges faced by Claims Research Analysts, and how can they effectively address them?

Claims Research Analysts often encounter challenges such as interpreting complex policy language, verifying the authenticity of supporting documents, and meeting tight deadlines. To address these, it's important to develop strong analytical and organizational skills, utilize available claims management software, and maintain clear communication with both internal teams and external parties. Proactively seeking clarification from experienced colleagues and participating in ongoing training can also help analysts stay updated on industry practices and regulatory changes.
More about Claims Research Analyst jobs
What job categories do people searching Claims Research Analyst jobs look for? The top searched job categories for Claims Research Analyst jobs are:
Claims Research Analyst jobs near you
Infographic showing various Claims Research Analyst job openings in the United States as of June 2026, with employment types broken down into 92% Full Time, 6% Part Time, and 2% 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.

Claims Research Analyst

Ourhrconnect

Carolina, RI • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 hours ago

Job description


Summary
 This position completes research efficiently and accurately to ensure the departmental goals to prevent aging of claims and erroneous disbursements or claims from processing incorrectly. This position also assists in any special projects that may arise.
Description
 

Location: This position is full-time (40 hours/week) Monday-Friday from 8:00am-4:30pm and will be fully remote.

What You'll Do:

  • Verify disbursement requests to ensure the request is valid and appropriately documented. Research rejected, transition, and paid status claims for validity and escalate as appropriate. Use the various systems of the department/company to complete research and gain sufficient knowledge of the claims system and how it relates to other systems.

  • May research claims to identify or validate fraud, waste or abuse.

  • Monitor inventory reports to ensure claims are resolved accordingly. Provide documentation as requested for audit purposes. May provide written or telephone correspondence to resolve claims issues.

  • Serves as a point of contact for various providers, professional and facility. Research claims as related to billing or crediting groups. Research claims to ensure the proper adjustments are made and groups receive credit or are billed appropriately.

To Qualify For This Position, You'll Need The Following:

  • Required Education: High School Diploma or equivalent

  • Required Work Experience: 3 years of experience processing claims in a healthcare environment. 2 years of experience with claims systems (can be concurrent).

  • Required Skills and Abilities:

  • In-depth knowledge of claims payment policies and refund policies.

  • Knowledge of related claims software systems.

  • Knowledge of medical terminology, CPT IV coding, ICD 9 diagnosis codes, or NCPDP coding as appropriate.

  • Good analytical skills and the ability to retrieve and research automated reports.

  • Good time management skills and adaptable to change.

  • Good communication skills, both written and verbal.

  • Required Software and Other Tools: Standard office equipment.

We Prefer That You Have The Following:

  • Preferred Education: Bachelor's degree-in Business, Computer Science, Healthcare Administration, or a related field.

  • Preferred Work Experience: 4 years-of related experience if lacking degree.

  • Preferred Skills and Abilities:

  • Knowledge of processing systems - RMMS, CES, AMMS, ITS, SOND, INFO, third party recovery display, and ALGS.

  • Excellent written and verbal communication skills.

  • Knowledge of electronic data processing systems and procedures and their integration with the users.

  • Ability to run reports using pre-set data retrieval applications, such as DB2 and EZTRIEVE Plus, to obtain information for research and analysis.

  • Problem-solving skills

Our Comprehensive Benefits Package Includes The Following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

  • Subsidized health plans, dental and vision coverage

  • 401k retirement savings plan with company match

  • Life Insurance

  • Paid Time Off (PTO)

  • On-site cafeterias and fitness centers in major locations

  • Education Assistance

  • Service Recognition

  • National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What To Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation.

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