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Medical Claim Analyst

Detroit, MI · On-site

$38 - $40/hr

Claims System Analyst Location: Detroit MI, Hybrid Job Overview Resource needed to support teams with project funded work with focus on new groups, new segments and large corporate projects. Top 3 ...

CogniSoft Technologies

System Analyst II

Detroit, MI · On-site

🚨 Hiring: Systems Analyst II 📍 Location: Detroit, MI (Hybrid - 2 days onsite) We''re looking for a Systems Analyst II with experience in: ✅ NASCO 3270 Mainframe ✅ Medical Claims ...

ClinDCast LLC

Healthcare System Analyst

Mason, OH

The candidate should possess strong knowledge of healthcare claims, enrollment, provider, and ... Analyze business and system requirements for healthcare payer applications. * Work with ...

Carman Solutions Group

Claims Tester

Malvern, PA · On-site

Title: Claims Tester Location: Remote Duration: Long-term visa- independent visa holders ... Should be able to run queries and perform basic system analysis, RCA etc., * Should work closely ...

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Navtech

Business Analyst

Buffalo, NY · On-site

Bring data from various policy and claims system / platforms into one confined data model by ... Analytics requirements collection with business interface. * Experience in mapping multiple data ...

SWBC

Mortgage Claims Processor

San Antonio, TX · On-site

$15.50 - $19.50/hr

Review claims statuses and notate the claims system with the status. * Proven research skills with ability to quickly locate and analyze relevant data * High level of self-motivation and discipline ...

SWBC

Mortgage Claims Processor

$17.50 - $22/hr

Review claims statuses and notate the claims system with the status. * Proven research skills with ability to quickly locate and analyze relevant data * High level of self-motivation and discipline ...

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How much do claims system analyst jobs pay per hour?

As of Jul 4, 2026, the average hourly pay for claims system 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 Claims System Analyst?

A Claims System Analyst is a professional who manages and maintains the software systems used to process insurance claims. They analyze system performance, troubleshoot issues, implement updates, and ensure data accuracy within claims processing platforms. These analysts often work with IT teams and business stakeholders to optimize workflow, improve system efficiency, and support regulatory compliance. Their role is crucial in ensuring that claims are processed smoothly and accurately.

What is the difference between Claims System Analyst vs Claims Processor?

AspectClaims System AnalystClaims Processor
Required CredentialsBachelor's degree in IT, Business, or related field; knowledge of claims softwareHigh school diploma or equivalent; on-the-job training
Work EnvironmentOffice setting, working with IT teams and claim systemsOffice or remote, handling claim documentation and data entry
Employer & Industry UsageInsurance companies, healthcare providers, third-party administratorsInsurance companies, healthcare providers, claims departments
Common Search & ComparisonClaims System Analyst vs Claims Processor

The Claims System Analyst focuses on managing and improving claims software systems, requiring technical skills and analytical abilities. In contrast, Claims Processors handle the day-to-day processing of claims, emphasizing attention to detail and customer service. Both roles are essential in the claims industry but differ in responsibilities and skill requirements.

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

To thrive as a Claims System Analyst, you need strong analytical skills, attention to detail, and a background in information systems or a related field, often supported by a relevant degree or industry experience. Familiarity with claims management software, SQL databases, and process automation tools is typically required, and certifications such as CPCU or AIC can be advantageous. Excellent problem-solving, communication, and teamwork abilities help analysts collaborate effectively with IT and business stakeholders. These skills ensure accurate claims processing, system optimization, and seamless integration of technology with business objectives.

What are some common challenges a Claims System Analyst faces when supporting system upgrades or implementations?

A Claims System Analyst often encounters challenges such as ensuring data integrity during migration, aligning system functionalities with constantly evolving business rules, and minimizing disruptions to ongoing claims processing. Collaborating across teams—like IT, business users, and vendors—is essential to address integration issues and user acceptance testing. Proactively communicating changes and providing thorough documentation helps ease transitions and supports end-users effectively.
More about Claims System Analyst jobs
What job categories do people searching Claims System Analyst jobs look for? The top searched job categories for Claims System Analyst jobs are:
Claims System Analyst jobs near you
Claims System Conversion Consultant

Claims System Conversion Consultant

Mount Carmel Health System

Columbus, OH • On-site

Part-time

Medical, Dental, Vision

Posted 25 days ago

Mount Carmel Health System rating

8.2

Company rating: 8.2 out of 10

Based on 17 frontline employees who took The Breakroom Quiz

Job description

Employment Type:Part timeShift:Day Shift Description:Support Director of Claims Operations and Manager of System Configuration during implementation of new claims system
  • Provider Data Management and related downstream processes
  • Manages System Configuration functional area purchases and ensures the proper processing of all invoices related to assigned activities.
  • Lead the definition, documentation, implementation and continuous improvement of claims adjudication system management policies, standards and processes.
  • Supports Claims Audit leadership with the analysis of claims processing metrics to ensure optimal performance.
  • Ensures compliance with all regulatory requirements impacting Support Services by collaborating with the Compliance Department and other key functional stakeholders within the organization responsible for execution of policies, standards and processes.
  • Establish partnerships and works closely with key operational and clinical staff to ensure claims system configuration accuracy; develop plans to address any potential system inaccuracies or configuration errors.
  • Investigate and recommend implementation of tools, techniques and processes with potential to improve management of system configuration.
  • Participate in compliance audits and remediate issues identified as required.
  • Provide Subject Matter Expertise throughout the implementation of the new claims system, HealthEdge Healthrules Payor (HRP)
  • Support Director, Claims Operations and Configuration with daily activities and escalation requests throughout the HRP implementation thus enabling Director to commit more resources to the HRP implementation.
  • Support Manager, System Configuration with daily activities and escalation requests throughout the HRP implementation thus enabling Director to commit more resources to the HRP implementation.
  • Education:  Bachelor of Science degree in health care, business administration, or related field preferred.  In lieu of a bachelor’s degree an combination of college course work and 7+ years of experience in managed care or a health plan organization demonstrating ascending roles of responsibility will be considered.
  • Advanced knowledge of health plan medical benefits, provider reimbursement methodologies, medical, dental and vision terminology, advanced knowledge of claim adjudication and benefit plan application for Medicare Advantage plans.
  • Advanced knowledge of CPT, ICD-9, ICD-10 and HCPS coding systems.
  • Uses standard office equipment and must be able to operate a motor vehicle and possess a valid driver's license.
  • Participates in all project related reporting and communication to the steering committee and other stakeholders.
  • Responsible for compliance with Organizational Integrity through raising questions and promptly reporting actual or potential wrongdoing.
  • Clearly articulates assignments and direction
  • Foster teamwork

Our Commitment to Diversity and Inclusion
 

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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