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Medical Claim Analyst Jobs (NOW HIRING)

Secure Eclaims LLC

Medical Claim Analyst

Miami, FL

* Reviews all medical/surgical billings for reasonable and necessary charges. Examines coding of operative reports, procedures, and multiple and complicated surgeries. * Performs hospital length of ...

Secure Eclaims LLC

Medical Claim Analyst

Miami, FL · On-site

* Reviews all medical/surgical billings for reasonable and necessary charges. Examines coding of operative reports, procedures, and multiple and complicated surgeries. * Performs hospital length of ...

Luminare Health

Sr Claims Analyst - LHB

High School diploma or GED equivalent * 3 years prior medical claim processing experience * Ability ... Ability to analyze and interpret documents and Summary Plan Descriptions (SPDs) * Ability to adapt ...

The Reny Company

Medical Claim Processor

Plano, TX · On-site

$18.50 - $21/hr

THIS IS NOT A REMOTE POSITION The Reny Company's medical claim processor is a professional who ... Effective analytical and interpersonal skills Company Description The Reny Company is a rapidly ...

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Medical Claim Analyst information

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How much do medical claim analyst jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for medical claim 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.

How much do medical claim analysts make in the US?

Medical claim analysts in the US typically earn a median annual salary of around $45,000 to $65,000, depending on experience, location, and certifications. Entry-level positions may start lower, while experienced analysts with specialized skills can earn higher salaries and additional benefits.

How to become a medical claim analyst?

To become a medical claim analyst, candidates typically need a high school diploma or equivalent, with some roles preferring an associate's or bachelor's degree in health administration, finance, or related fields. Relevant skills include knowledge of insurance policies, medical billing, and claims processing software; certifications such as the Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can enhance job prospects. On-the-job training is common, and strong attention to detail and analytical skills are essential for success in this role.

What does a medical claim analyst do?

A Medical Claim Analyst reviews and processes medical insurance claims submitted by healthcare providers or policyholders. They examine the accuracy and completeness of the claims, verify patient eligibility and coverage, and ensure that the services billed are covered by the insurance policy. Medical Claim Analysts also identify potential errors, discrepancies, or fraudulent activities in claims and communicate with providers or members to resolve issues. Their work helps ensure timely and accurate reimbursement for medical services and maintains the integrity of the claims process.

What is the difference between Medical Claim Analyst vs Medical Billing Specialist?

AspectMedical Claim AnalystMedical Billing Specialist
CredentialsTypically requires a certification like CPC or similarOften requires certification but less specialized
Work EnvironmentInsurance companies, healthcare providers, or third-party payersMedical offices, clinics, or billing companies
Job FocusAnalyzing and processing insurance claims, ensuring accuracyPreparing and submitting patient bills, following up on payments

While both roles involve handling healthcare financial transactions, Medical Claim Analysts focus on reviewing and processing insurance claims for accuracy and reimbursement, whereas Medical Billing Specialists primarily prepare and submit patient bills and follow up on payments. Both roles require knowledge of medical coding and insurance policies but differ in their core responsibilities and work settings.

What are some common challenges medical claim analysts face when reviewing complex claims?

Medical Claim Analysts often encounter challenges such as interpreting varying coding standards, handling incomplete or ambiguous documentation, and staying updated with constantly changing healthcare regulations. Managing high volumes of claims while ensuring accuracy can also be demanding, especially when claims involve specialized procedures or multi-layered insurance policies. Strong attention to detail, effective communication with providers or patients, and ongoing training help analysts overcome these obstacles and ensure timely, accurate claim processing.

What is a medical claim analyst?

A medical claim analyst reviews and processes insurance claims related to healthcare services to ensure accuracy and compliance with policies. They analyze claim data, identify discrepancies, and work with healthcare providers and insurance companies, often using specialized software and requiring knowledge of medical billing and coding. This role typically involves attention to detail and understanding of healthcare regulations.

What are the key skills and qualifications needed to thrive as a medical claim analyst, and why are they important?

To thrive as a Medical Claim Analyst, you need a solid understanding of medical terminology, insurance guidelines, and claims processing, often supported by a relevant associate degree or certification. Familiarity with claims management software, ICD-10/CPT coding systems, and electronic health record (EHR) platforms is typically required. Strong attention to detail, analytical thinking, and effective communication skills help analysts resolve discrepancies and collaborate with healthcare providers. These skills ensure accurate claim evaluations, minimize errors, and contribute to efficient reimbursement processes in healthcare organizations.
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Medical Claim Analyst jobs near you
Infographic showing various Medical Claim Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $52,237 per year, or $25.1 per hour.

Medical Claim Analyst

Secure Eclaims LLC

Miami, FL

Full-time

Re-posted 16 days ago

Job description

  • Reviews all medical/surgical billings for reasonable and necessary charges. Examines coding of operative reports, procedures, and multiple and complicated surgeries.
  • Performs hospital length of stay reviews to determine reasonable and necessary care, and appropriateness of stay. Recommends appropriate payments of dispute of billing, as necessary.
  • Provides second review of bills on which providers question the appropriateness of payments authorized.
  • Evaluates claims referred for medical management and makes recommendations for follow-up, further investigation or documentation as necessary.
  • Trains and assists claims staff on quality health care cost containment and utilization reviews.

Company Description

Leading specialty benefits management company in Puerto Rico and South Florida. Our innovative care management model integrates the needs of providers, payors and members to ensure the delivery of high quality, cost effective care while realizing substantial millions of dollars savings that keep the cost of healthcare down.

We are building a model for managing care delivery that embodies traditional values, promises reliability, and embraces flexibility and technology. Through our experience in the healthcare industry, the company aims to improve healthcare outcomes, achieve cost savings and serve as a single point of contact to move into value-based care.