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Medicaid Claims Processing Jobs (NOW HIRING)

CYNET SYSTEMS

Medicaid Claims Analyst

Parsippany, NJ · On-site

$55 - $60/hr

Responsible for processing, validating, analyzing, and resolving Medicaid claims while ensuring compliance with Medicaid regulations, rebate systems, and data accuracy standards. Experience: * Prior ...

OmegaHires

Medicaid Data Architect

Austin, TX · On-site

$63.25 - $81.25/hr

... Medicaid Claims Processing. Responsibilities : • Collaborating with business and technical stakeholders to analyze, develop, and test system enhancements within a government agency environment ...

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Memorial Health

Medicaid Specialist

Springfield, IL · On-site

$18.34 - $28.42/hr

Prioritizes claims based on specified criteria and electronically files the claim, ensuring careful adherence to Medicaid guidelines, timeliness, accuracy, and processing procedures. At prescribed ...

Barrow Wise Consulting

Medicaid/Medicare Consultant

MD · On-site

$90K - $150K/yr

Provide and manage consulting, data transfer, and claims processing services to increase federal revenues in Medicare A, B, D, and Medicaid in IDHS State Operated Facilities * Provide revenue ...

Memorial Health

Medicaid Specialist

Springfield, IL · Remote

$18.34 - $28.42/hr

Prioritizes claims based on specified criteria and electronically files the claim, ensuring careful adherence to Medicaid guidelines, timeliness, accuracy, and processing procedures. At prescribed ...

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Medicaid Claims Processing information

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$12

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$26

How much do medicaid claims processing jobs pay per hour?

As of Jun 11, 2026, the average hourly pay for medicaid claims processing in the United States is $19.16, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $20.67 per hour, depending on experience, location, and employer.

What is a Medicaid Claims Processing job?

A Medicaid Claims Processing job involves reviewing, verifying, and processing healthcare claims submitted by providers seeking reimbursement for services rendered to Medicaid beneficiaries. Workers in this role ensure claims comply with state and federal regulations, identify errors or discrepancies, and communicate with healthcare providers to resolve issues. They may also use specialized software to input and track claims, process denials or appeals, and ensure timely and accurate payments. Strong attention to detail, knowledge of Medicaid policies, and proficiency with healthcare billing codes are essential for success in this role.

What are some typical challenges faced in Medicaid Claims Processing, and how can I prepare for them?

One of the main challenges in Medicaid Claims Processing is staying up-to-date with frequently changing policies, billing codes, and compliance requirements, which can vary by state and program. Professionals in this role must pay close attention to detail to avoid errors and denials, often working with tight deadlines and large volumes of claims. To prepare, it's helpful to become familiar with Medicaid guidelines, maintain strong organizational habits, and proactively seek out updates in regulations or coding standards. Collaborating with other team members, such as care coordinators and billing specialists, is essential to ensure claims are accurate and properly documented. Ongoing learning and adaptability are key for long-term success in this dynamic environment.

What are the key skills and qualifications needed to thrive in the Medicaid Claims Processing position, and why are they important?

Success in Medicaid Claims Processing requires excellent attention to detail, a thorough understanding of healthcare billing procedures, and familiarity with Medicaid regulations and insurance guidelines. Proficiency in medical billing software, claims management systems, and sometimes industry certifications such as Certified Professional Coder (CPC) is beneficial. Strong organizational skills, problem-solving abilities, and effective written and verbal communication help individuals excel in this role. These skills and qualifications are crucial for ensuring accurate, timely claims processing and compliance with ever-evolving Medicaid requirements.

More about Medicaid Claims Processing jobs
What cities are hiring for Medicaid Claims Processing jobs? Cities with the most Medicaid Claims Processing job openings:
What are the most commonly searched types of Medicaid Claims Processing jobs? The most popular types of Medicaid Claims Processing jobs are:
What states have the most Medicaid Claims Processing jobs? States with the most job openings for Medicaid Claims Processing jobs include:
What job categories do people searching Medicaid Claims Processing jobs look for? The top searched job categories for Medicaid Claims Processing jobs are:
Medicaid Claims Processing jobs near you
Infographic showing various Medicaid Claims Processing job openings in the United States as of June 2026, with employment types broken down into 93% Full Time, 5% Part Time, and 2% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $39,863 per year, or $19.2 per hour.
Business Analyst - Medicaid Claims Processing

Business Analyst - Medicaid Claims Processing

SMX Services & Consulting, Inc.

Austin, TX • Hybrid

Other

Posted 5 days ago

Job description


Business Analyst - Medicaid Claims Processing

Location: Austin, TX (Hybrid - 2 days onsite: Monday & Tuesday; 3 days remote)

Duration: Multi-Year Contract

Start Date: July 1, 2026

Position Overview

We are seeking an experienced Business Analyst with a strong background in Medicaid Claims Processing to support a long-term project in Austin, Texas. The ideal candidate will possess excellent analytical, documentation, stakeholder management, and requirements-gathering skills, along with experience working in Agile environments and collaborating with both technical and business teams.

Required Experience (Minimum 5 Years in Each Area)

  • Medicaid Claims Processing
  • Business analysis, process improvement, and solution recommendations
  • Gathering, reviewing, analyzing, and documenting business and system requirements
  • Evaluating operational procedures and identifying opportunities for improvement
  • Creating business requirements, use cases, process flows, and functional specifications
  • Cost-benefit analysis and evaluation of alternative system solutions
  • Input/output analysis, reporting requirements, and data summarization processes
  • Azure DevOps and wireframe creation
  • Data integrity, security standards, policies, and procedures
  • Agile/Scrum methodologies

Required Skills

  • Strong analytical and problem-solving abilities
  • Excellent verbal and written communication skills
  • Strong stakeholder management and interpersonal skills
  • Understanding of application architecture, infrastructure, and enterprise systems
  • Knowledge of IT industry trends, emerging technologies, and best practices

Preferred Experience

  • Texas DIR Project Delivery Framework (PDF)
  • DIR documentation standards and templates
  • Information architecture and information management methodologies
  • Enterprise software architecture and infrastructure environments

Key Responsibilities

  • Gather, analyze, and document business requirements, use cases, process flows, and acceptance criteria
  • Evaluate existing business processes and assess the impact of proposed changes
  • Serve as a liaison between business stakeholders and technical teams throughout the SDLC
  • Assist with project documentation, user guides, and online help content
  • Develop and execute test scripts and support defect resolution activities
  • Provide project status updates, issue tracking, and stakeholder communications
  • Facilitate knowledge transfer sessions and support system architecture reviews
  • Ensure solutions comply with HHSC and DIR standards and guidelines

Note: Local Austin-area candidates with strong Medicaid Claims Processing experience will receive priority consideration.

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