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Full Time Claims Quality Analyst Jobs (NOW HIRING)

NYC Health Hospitals

Claims Quality Analyst

New York, NY · On-site

$55K - $65K/yr

Position Overview The Claims Quality Analyst is responsible for reviewing claims to determine if payments have been made correctly. This position analyzes data used in settling claims to determine ...

Brookfield

Senior Claims Quality Analyst

Omaha, NE

$64K - $90K/yr

The Quality Improvement job family serves the claims operation in a variety of capacities, most of ... Analyze audit results and perform focused audits on specific trends as needed to identify gaps and ...

Brookfield

Senior Claims Quality Analyst

Albany, NY · On-site

$64K - $90K/yr

The Quality Improvement job family serves the claims operation in a variety of capacities, most of ... Analyze audit results and perform focused audits on specific trends as needed to identify gaps and ...

Imagenet

Claims Quality Auditor - Remote

Tampa, FL · On-site +1

Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor ... Analyze provider disputes for patterns or recurring issues. * Identify root causes and work with ...

Dane Street, LLC

Claims Quality Analyst, NY

JOB SUMMARY The Quality Analyst is responsible for managing the various aspects of the medical file ... We process over 200,000 insurance claims annually for leading national and regional Workers ...

Imagenet

Claims Quality Auditor - Remote

Tampa, FL · Remote

Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor ... Analyze provider disputes for patterns or recurring issues. * Identify root causes and work with ...

Archgroup

Claims Data Quality Analyst

Home, WA · Hybrid

$75K - $95K/yr

Position Summary The Claims Division is seeking a team member to join the Claims Operations Team as a Data Quality Analyst. In this role the responsibilities include, but not limited to, examining ...

Archgroup

Claims Data Quality Analyst

New York, NY · Hybrid

$75K - $95K/yr

Position Summary The Claims Division is seeking a team member to join the Claims Operations Team as a Data Quality Analyst. In this role the responsibilities include, but not limited to, examining ...

Archgroup

Claims Data Quality Analyst

Dallas, TX · Hybrid

$75K - $95K/yr

Position Summary The Claims Division is seeking a team member to join the Claims Operations Team as a Data Quality Analyst. In this role the responsibilities include, but not limited to, examining ...

Archgroup

Claims Data Quality Analyst

Garden City, NY · Hybrid

$75K - $95K/yr

Position Summary The Claims Division is seeking a team member to join the Claims Operations Team as a Data Quality Analyst. In this role the responsibilities include, but not limited to, examining ...

Archgroup

Claims Data Quality Analyst

Jersey City, NJ · Hybrid

$75K - $95K/yr

Position Summary The Claims Division is seeking a team member to join the Claims Operations Team as a Data Quality Analyst. In this role the responsibilities include, but not limited to, examining ...

Archgroup

Claims Data Quality Analyst

New York, NY · Hybrid

$75K - $95K/yr

Position Summary The Claims Division is seeking a team member to join the Claims Operations Team as a Data Quality Analyst. In this role the responsibilities include, but not limited to, examining ...

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Full Time Claims Quality Analyst information

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$14

$27

$51

How much do full time claims quality analyst jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for full time claims quality 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 the difference between Full Time Claims Quality Analyst vs Part Time Claims Quality Analyst?

AspectFull Time Claims Quality AnalystPart Time Claims Quality Analyst
Work HoursTypically 35-40 hours per weekLess than 30 hours per week
ResponsibilitiesFull scope of claims review, quality assurance, and process improvementFocused on specific claims or tasks, limited scope
CredentialsUsually requires similar certifications (e.g., CPC, CPC-A)Same certifications often required
Work EnvironmentOffice or remote, full-time schedulePart-time, flexible hours, similar environment

Full Time Claims Quality Analysts work full-time hours with comprehensive responsibilities in claims review and quality assurance, while Part Time Claims Quality Analysts have reduced hours with focused tasks. Both roles often require similar certifications and work in comparable environments, but differ mainly in hours and scope of duties.

More about Full Time Claims Quality Analyst jobs
What cities are hiring for Full Time Claims Quality Analyst jobs? Cities with the most Full Time Claims Quality Analyst job openings:
What are the most commonly searched types of Claims Quality Analyst jobs? The most popular types of Claims Quality Analyst jobs are:
What states have the most Full Time Claims Quality Analyst jobs? States with the most job openings for Full Time Claims Quality Analyst jobs include:
What job categories do people searching Full Time Claims Quality Analyst jobs look for? The top searched job categories for Full Time Claims Quality Analyst jobs are:
Full Time Claims Quality Analyst jobs near you
Infographic showing various Full Time Claims Quality Analyst job openings in the United States as of July 2026, with employment types broken down into 89% Full Time, 6% Part Time, 1% Temporary, and 4% Contract. Highlights an 83% Physical, 7% Hybrid, and 10% Remote job distribution, with an average salary of $56,974 per year, or $27.4 per hour.
Claims Quality Analyst

Claims Quality Analyst

NYC Health Hospitals

New York, NY • On-site

$55K - $65K/yr

Full-time

Medical, Retirement, PTO

Posted 11 days ago

NYC Health + Hospitals rating

7.7

Company rating: 7.7 out of 10

Based on 73 frontline employees who took The Breakroom Quiz

160th of 890 rated healthcare providers

Job description

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.
Position Overview
The Claims Quality Analyst is responsible for reviewing claims to determine if payments have been made correctly. This position analyzes data used in settling claims to determine the validity of payment of claims and reports overpayments, underpayments and other irregularities based upon benefit configuration, compliance with provider contract agreements, and Federal, State and Plan's established guidelines and/or policies and procedures. The incumbent will research, review, and suggest process improvements, training opportunities and is a resource of information to all staff. The incumbent will also perform special projects.
Work Shifts
9:00 A.M - 5:00 P.M
Duties & Responsibilities
  • Audit daily processed claims through random selection based on set criteria.
  • Document, track, and trend findings per organizational guidelines
  • Based upon trends, determine ongoing Claims Examiner training needs, and assist in the development of training curriculum.
  • Conduct in-depth research of contract issues, system-related problems, claims processing Policies and Procedures, etc., to confirm cause of trends. Recommend actions/resolutions.
  • Work with other organizational departments to develop corrective action plans to improve accuracy of the claims adjudication processes and assure compliance with organizational
    requirements and applicable regulations
  • Assist in the development of Claims policies and procedures
  • Provide backup for other trainers within
    the department
  • Assist in training of new departmental staffs
  • Assist with the research and resolution of audit appeal
  • Asist with external/internal regulatory audits
  • Identify policies or common errors requiring retraining sessions.
  • Participate in quality projects as required.
  • Collect, analyze data, identify trends, write reports (i.e., the monthly and quarterly reports) and present findings to the appropriate claims service management personnel.
  • Other duties as assigned by senior management

Minimum Qualifications
  • Associate degree required; Bachelor's degree preferred
  • Minimum of 4 years of experience performing claims quality audits in a NYS-based managed care setting
  • Expertise in both professional and institutional claims coding, and coding rules required.
  • Definitive understanding of provider and health plan contracting, delineation of risk, medical terminology and standard industry reimbursement methodologies required.
  • Strong knowledge of CMS Medicare and NYS regulations required.
  • Experience in training development and presentation preferred

Professional Competencies
  • Strong organizational, analytical, and oral/written communication skills required.
  • Proficiency in PC application skills, e.g., excel, word, PowerPoint, etc.,
  • Must be able to follow direction and perform independently according to departmental
  • Integrity and Trust
  • Must have excellent interpersonal, verbal, and written communication skills

#LI-Hybrid
#MHP50
Benefits
NYC Health and Hospitals offers a competitive benefits package that includes:
  • Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
  • Retirement Savings and Pension Plans
  • Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
  • Loan Forgiveness Programs for eligible employees
  • College tuition discounts and professional development opportunities
  • College Savings Program
  • Union Benefits for eligible titles
  • Multiple employee discounts programs
  • Commuter Benefits Programs

What NYC Health + Hospitals employees say

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