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Claims System Analyst Jobs (NOW HIRING)

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY

$18.75 - $23.75/hr

... system (QNXT) * Good knowledge of International Classification of Diseases (ICD-9, ICD-10) and ... Demonstrated organizational, perform multiple priorities, and analytical skills with the ability to ...

Spectra force

Claims Clerk I

Columbia, SC · On-site

... system. Ensure claims are processed in a timely manner. 80% Screen, code and key claims to ensure ... Strong organizational and analytical skills. Strong verbal and written communication skills.

SPECTRAFORCE

Claims Clerk I

Columbia, SC

... system. Ensure claims are processed in a timely manner. 80% Screen, code and key claims to ensure ... Strong organizational and analytical skills. Strong verbal and written communication skills.

MD Anderson

EHR System Analyst - HB Coding

Houston, TX · On-site +1

The EHR Systems Analyst is responsible for developing and maintaining in-depth knowledge of the ... Preferred qualifications include at least 3 years of hospital billing or hospital billing claims ...

MD Anderson

EHR System Analyst - HB Coding

Houston, TX · On-site +1

The EHR Systems Analyst is responsible for developing and maintaining in-depth knowledge of the ... Preferred qualifications include at least 3 years of hospital billing or hospital billing claims ...

MD Anderson

EHR System Analyst - HB Coding

Houston, TX · On-site +1

The EHR Systems Analyst is responsible for developing and maintaining in-depth knowledge of the ... Preferred qualifications include at least 3 years of hospital billing or hospital billing claims ...

EMC Insurance Group, Inc.

Claims Enablement Analyst

$73K - $100K/yr

As a Claims Enablement Analyst, you'll support Claims teams by resolving complex system and process issues, identifying root causes, and delivering timely solutions that improve daily operations. You ...

Trean Corporation

Senior Claims Adjuster

Ontario, CA

$85K - $95K/yr

... System. In the event actual payroll documentation cannot be obtained from the employer an ... Excellent analytical skills and verbal and written communication skills * Strong organizational ...

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How much do claims system analyst jobs pay per hour?

As of Jul 5, 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.
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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
Hospital Claims Processor V

Hospital Claims Processor V

1199SEIU Funds

Manhattan, NY

$18.75 - $23.75/hr

Full-time

Medical

Posted 4 days ago

Job description

Responsibilities

  • Review hospital claims and determine action needed to resolve pended claims
  • Process and evaluate hospital claims manually or through claims work flow
  • Validate information entered in hospital claims module (QNXT); determine the process or work flow needed to resolve discrepancies
  • Finalize hospital claims by applying knowledge of eligibility, benefits, pre-authorization rules, contractual policy and operational procedures
  • Review, finalize and respond to call tracking tickets in a timely manner to provider inquires
  • Perform additional duties and special projects as assigned by management


Qualifications

  • High School Diploma or GED required, some College or Degree preferred
  • Minimum two (2) years experience entering and updating hospital or medical claims in a health insurance or benefits environment required
  • Basic keyboarding skills required
  • Strong knowledge of hospital claims, eligibility, benefits, and reauthorization rules; knowledge of health claims system (QNXT)
  • Good knowledge of International Classification of Diseases (ICD-9, ICD-10) and Current Procedural Terminology (CPT) codes
  • Demonstrated organizational, perform multiple priorities, and analytical skills with the ability to follow through on assignments
  • Able to work well independently and in a team environment
  • Ability to meet strict deadlines, work well under pressure and in a fast-paced environment
  • Must meet performance standards including attendance and punctuality
Employment Type: Full time

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