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Home Based Medical Claims Analyst Jobs (NOW HIRING)

Searhc

Medical Claims Analyst

Juneau, AK

$31.83 - $44.56/hr

Pay Range:$31.83 - $44.56 The Medical Claims Analyst is responsible for supporting the accuracy, completeness, and compliance of medical claims processing and related Purchased/Referred Care (PRC ...

Professional Healthcare Solutions, LLC

Be Seen First

RN/Medical Claims Analyst

Houston, TX · Remote

$32.50 - $34/hr

Responsibilities may include additional research on medical claims data and other sources of ... Ability to make claim payment decisions based on clinical knowledge * Ability to compose medical ...

Delaware Claims

Claims Analyst

Wilmington, DE · On-site

$52K/yr

... package includes medical, dental, vision, disability, parking stipend, 401-K, generous PTO ... home plans, flexible schedules, casual environment, work-life balance, supportive leadership ...

Delaware Claims

Claims Analyst

Wilmington, DE · On-site

$52K/yr

... package includes medical, dental, vision, disability, parking stipend, 401-K, generous PTO ... home plans, flexible schedules, casual environment, work-life balance, supportive leadership ...

Integrated Resources INC

Claims Analyst I

Syracuse, NY · On-site

Looking for medical claims experience for these position Top Three: Claims knowledge, efficient and ... based on configuration changes/updates to support new businesses, benefits, and contracts. Applies ...

Moda Health

Medical Claims Processor I

Milwaukie, OR · Hybrid

$17.34 - $19.41/hr

This is a FT WFH role. Pay Range $17.34 - $19.41 hourly, DOE. *Actual pay is based on ... Analytical reasoning and flexibility * Professional and effective written and verbal communication ...

MagMutual LLC

Claims Analyst

Atlanta, GA · On-site

The Claims Analyst is responsible for investigating and managing primary litigation claims as ... Assign a Medical Advisor when required. * Thoroughly, accurately, and timely document case files

MAG Mutual Insurance

Claims Analyst

Atlanta, GA · On-site

The Claims Analyst is responsible for investigating and managing primary litigation claims as ... Assign a Medical Advisor when required. * Thoroughly, accurately, and timely document case files

Primma, LLC

Claims Analyst Trainee

Roslyn, NY · On-site

$27.47/hr

Obtain all pertinent information from Insured (s) regarding the service of legal papers and medical ... Collaborate with Claims Analyst / Management on the review of legal and vendor invoices received ...

SIHO Insurance Services

Claims Analyst

Columbus, IN · On-site

Brief Description of Duties: * Review incoming medical, pharmacy vision and dental claims ... Resolve identified claims issues based on CCI edit repot to comply with CMS guidelines. * Represent ...

Primma, LLC

Claims Analyst Trainee

Roslyn, NY · On-site

$27.47/hr

Obtain all pertinent information from Insured (s) regarding the service of legal papers and medical ... Collaborate with Claims Analyst / Management on the review of legal and vendor invoices received ...

SIHO HOLDING INC

Claims Analyst

Columbus, IN · On-site

Brief Description of Duties: * Review incoming medical, pharmacy vision and dental claims ... Resolve identified claims issues based on CCI edit repot to comply with CMS guidelines. * Represent ...

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Home Based Medical Claims Analyst information

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How much do home based medical claims analyst jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for home based medical claims analyst in the United States is $25.11, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $25.24 per hour, depending on experience, location, and employer.
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What are the most commonly searched types of Medical Claims Analyst jobs? The most popular types of Medical Claims Analyst jobs are:
What states have the most Home Based Medical Claims Analyst jobs? States with the most job openings for Home Based Medical Claims Analyst jobs include:
Home Based Medical Claims Analyst jobs near you

Medical Claims Analyst

Searhc

Juneau, AK

$31.83 - $44.56/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 16 days ago

Job description

Pay Range:

Pay Range:$31.83 - $44.56 The Medical Claims Analyst is responsible for supporting the accuracy, completeness, and compliance of medical claims processing and related Purchased/Referred Care (PRC) activities across the organization. This role performs claims review and processing, eligibility verification, referral validation, payment research, system administration, workflow support, and data integrity monitoring to ensure authorized services are processed accurately and timely. The position partners with PRC leadership, Finance, providers, internal departments, and external vendors to resolve complex claims issues, support reporting needs, improve claims processing workflows, and strengthen operational performance. Additionally, the role supports training, special projects, system upgrades, audit preparation, policy updates, and process improvement initiatives that advance PRC program compliance, provider communication, and financial decision-making.

SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.

Working at SEARHC is more than a job, it's a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more.

Key Essential Functions and Accountabilities of the Job

  • Performs all duties of the Medical Claims Specialist role, including review, screening, eligibility verification, alternate health resource verification, referral validation, claim processing, claims research, customer service, and interpretation of PRC Program regulations, policies, and procedures for internal and external customers.

  • Serves as the system administrator for the PRC claims processing platform, including user access coordination, system configuration support, workflow maintenance, issue tracking, testing, troubleshooting, and coordination with internal departments and external vendors as needed.

  • Maintains data integrity within the claims processing system by monitoring claim data, validating system outputs, supporting timely correction of errors, and identifying opportunities to improve accuracy, efficiency, and consistency in claims processing workflows.

  • Develops and supports training for providers, PRC staff, internal departments, and other key stakeholders on claims submission requirements, claims status processes, system workflows, documentation expectations, and applicable PRC policies and procedures.

  • Supports reporting projects for finance leadership and the executive team by gathering, validating, analyzing, and summarizing claims data, utilization trends, outstanding liabilities, denial activity, payment status, and other information needed for operational, financial, and strategic decision-making.

  • Partners with PRC leadership, Finance, providers, and other stakeholders to resolve complex claims issues, improve claims processing workflows, support provider communication, and ensure accurate and timely payment of authorized services.

  • Assists with special projects, process improvement initiatives, system upgrades, audit support, policy updates, and other duties as assigned.

Additional Job Description

Education, Certifications, and Licenses Required

  • High school diploma or equivalent required.

  • Medical terminology course required or 1 year of documented experience in a medical field requiring consistent use of medical terminology.

  • Bachelors degree in health care administration, business, finance, information systems, or related field preferred.

Experience Required

  • 2 years of data entry experience with basic knowledge of accounts payable processing, MS Excel, and MS Word software applications.

  • 4 years of business, medical office, claims processing, revenue cycle, health care finance, or related experience OR an equivalent combination of education and experience.

  • Experience processing medical claims in a tribal health organization preferred.

  • Experience with claims processing systems, system administration, reporting, training, workflow support, or process improvement preferred.

  • Medical coding background preferred.

Knowledge of

  • State, federal, and tribal health care programs.

  • Medical insurance process.

  • PRC Program regulations, policies, and procedures.

  • ICD, CPT, revenue, and diagnosis coding.

  • Claims processing systems, data entry standards, workflow controls, and system integrity practices.

  • Basic reporting concepts, data validation, and financial or operational analysis.

Skills in

  • Interpreting state, federal, and tribal contract health care guidelines.

  • Research, problem solving, claims analysis, and issue resolution.

  • Using claims processing systems, MS Excel, MS Word, and related reporting tools.

  • Training, presenting information, and communicating technical or process information to providers, staff, and other stakeholders.

  • Oral/written interpersonal communication and excellent customer service skills.

Ability to

  • Ability to multitask and manage competing priorities.

  • Ability to enter, review, and analyze large volumes of data timely and accurately.

  • Ability to work independently with minimal supervision and exercise sound judgment in resolving claims and system-related issues.

  • Ability to support users, troubleshoot workflow issues, and coordinate system-related follow-up with internal and external stakeholders.

  • Ability to prepare clear, accurate, and timely reporting to support finance leadership and executive decision-making.

  • Ability to respond quickly in urgent situations with attention to detail.

Required Certifications:

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

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