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Medical Claims Analyst Jobs (NOW HIRING)

KeyStaff

Billing & Claims Analyst

Pompano Beach, FL · On-site

$28 - $36/hr

Pompano Beach Schedule: 8:30am - 5:00pm Pay Rate: $28.00 - $36.00 The Billing & Claims Analyst is responsible for monitoring medical claims, tracking payments, reviewing billing issues, and ...

Integrated Resources INC

Claims Analyst

Syracuse, NY · On-site

Conducts analysis around various claims payment processes to ensure accuracy of system ... Looking for medical claims experience for these position. * Top Three: Claims knowledge, efficient ...

Coxhealth

CHP Claims Analyst

Springfield, MO · On-site

Medical, Vision, Dental, Retirement with Employer Match and more (20+ hrs/week) * For a comprehensive list of benefits, please click here:Benefits | CoxHealth The Claims Analyst reviews and ...

OpTech LLC

Medicare Claims Analyst

Detroit, MI · On-site

Medical claims analysis (Medicare Advantage preferred) * Understanding of medical benefits * Data Analytical and reporting (include dashboards) * Systems Testing & Defect resolution with partners

Next Step Systems

Medical Claims Coder

Tucson, AZ · On-site

Medical Claims Coder, Tucson, AZ Under general supervision from the Director of Operations, the ... Conduct research and analysis of claims; facilitate resolution of specific claims issues. Monitor ...

OpTech LLC

Medicare Claims Analyst

Detroit, MI · On-site

Medical claims analysis (Medicare Advantage preferred) * Understanding of medical benefits * Data Analytical and reporting (include dashboards) * Systems Testing & Defect resolution with partners

Next Step Systems

Medical Claims Coder

Tucson, AZ · On-site

Medical Claims Coder, Tucson, AZ The Medical Claims Coder needs experience with ICD-10, Current ... Conduct research and analysis of claims; facilitate resolution of specific claims issues. Monitor ...

Next Step Systems

Medical Claims Examiner

Tucson, AZ · On-site

Medical Claims Examiner, Tucson, AZ Under general supervision from the Director of Operations, the ... Conduct research and analysis of claims; facilitate resolution of specific claims issues. Monitor ...

Next Step Systems

Medical Claims Examiner

Tucson, AZ · On-site

Medical Claims Examiner, Tucson, AZ The Medical Claims Examiner needs experience with ICD-10, ... Conduct research and analysis of claims; facilitate resolution of specific claims issues. Monitor ...

KYYBA

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Claims Systems Analyst - NASCO

Detroit, MI · On-site

$40 - $44/hr

Ability to complete medical claims analysis * Experience in system testing Required Skills/Experience - The rest of the required skills/experience. Include: * Ability to quickly learn new system ...

Next Step Systems

Medical Claims Examiner

Tucson, AZ · On-site

The Medical Claims Examiner is also responsible for monitoring copays, deductibles, insurance verification, and authorizations, analyzing incoming and outgoing revenue sources and measuring different ...

Healthcare Highways, Inc.

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Claims Data Analyst

Frisco, TX · On-site

$65K - $85K/yr

Analyze prospective clients' historical medical claims, eligibility, and provider data to evaluate provider disruption, network discounts, repriced costs, geographic access, and overall network fit.

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Medical Claims Analyst information

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$15

$25

$41

How much do medical claims analyst jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for 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.

What does a medical claims analyst do?

As a medical claims analyst, your responsibilities revolve around healthcare reimbursement, where you audit medical claims to ensure company reimbursement payments are accurate and reprice claims according to hospital payment schedules and Medicare reimbursement, which can be done manually or using computer software. You monitor electronic claims utilizing a processing system and provide detailed reporting on data such as claims volume, savings, and billed charges. You are expected to provide excellent customer service when working with customers and hospitals to resolve insurance claim issues, answer questions, and provide solutions to other problems related to medical claims. Other duties include abiding by all healthcare industry policies and regulations, staying updated on changing laws, and collaborating with the claims team to identify process gaps and improve your procedures.

What does a medical claims analyst do?

A Medical Claims Analyst reviews and processes medical insurance claims submitted by healthcare providers or patients. Their main role is to ensure claims are accurate, complete, and comply with policy guidelines and regulations. They investigate discrepancies, verify patient and provider information, and determine the amount of coverage or reimbursement. Additionally, they may communicate with healthcare providers, insurance companies, and patients to resolve issues or request additional information. Their work helps prevent fraud and ensures that claims are paid correctly and efficiently.

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

To thrive as a Medical Claims Analyst, you need a solid understanding of medical terminology, health insurance policies, and claims processing, often supported by a degree in healthcare administration or a related field. Familiarity with claims management software, medical coding systems (such as ICD-10 and CPT), and sometimes certification like Certified Professional Coder (CPC) is typically required. Attention to detail, analytical thinking, and effective communication are vital soft skills for accurately reviewing and processing claims. These skills ensure the correct adjudication of claims, minimize errors or fraud, and contribute to efficient healthcare reimbursement processes.

What are some common challenges faced by medical claims analysts and how can they be addressed?

Medical Claims Analysts often encounter challenges such as interpreting complex medical codes, identifying discrepancies in claims, and navigating frequent changes in insurance policies and regulations. Staying current with coding standards (like ICD-10 and CPT) and maintaining strong attention to detail are crucial for accuracy. Effective communication with healthcare providers and insurance companies also helps resolve ambiguities quickly. Regular training and collaboration with experienced colleagues can further enhance problem-solving skills and adaptability in this dynamic role.

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

AspectMedical Claims AnalystMedical Billing Specialist
CredentialsTypically requires a certification like CPC or CCSOften requires certification but less frequently
Work EnvironmentInsurance companies, healthcare providers, or third-party administratorsMedical offices, clinics, or billing companies
Job FocusAnalyzing and processing insurance claims, ensuring accuracyPreparing and submitting patient bills, following up on payments
Common UsageUsed in insurance and healthcare administrationUsed in healthcare provider billing departments

While both roles involve handling healthcare financial processes, Medical Claims Analysts focus on reviewing and processing insurance claims for accuracy and reimbursement, often requiring analytical skills and certifications. Medical Billing Specialists primarily handle the creation and submission of patient bills and follow-up, emphasizing billing procedures and customer service. Understanding these differences helps job seekers identify the right career path in healthcare finance.

Is claims processing a stressful job?

Medical Claims Analysts often work in fast-paced environments where accuracy and attention to detail are essential, which can lead to stress, especially when handling high volumes of claims or resolving complex issues. The job requires strong organizational skills and familiarity with claims processing software, and workload fluctuations can impact stress levels.
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Medical Claims Analyst jobs near you
Infographic showing various Medical Claims Analyst job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $52,237 per year, or $25.1 per hour.

Medical Claims Analyst - Contract

Scottsdale, AZ • On-site

krg technology inc
IT Services • 201 - 500 employees
Learn more about krg technology incexternal

Contractor

Re-posted 17 days ago

Job description

Job Description

Job Title : Medical Claims Analyst

Location : Scottsdale, AZ

Hiring Mode : Contract

Job Description

Review the scanned paper claims document and extracted information in an OCR application to ensure that there is no missing or incomplete information

Review couple of claims systems to identify the missing information and accurately capture the data/information necessary for processing

Correct the data elements extracted in OCR Application for self-learning where needed

Validate the claims that fall out while pre-load batch job into adjudication system, correct and re-load.

Additional Information

All your information will be kept confidential according to EEO guidelines.

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About KRG Technologies

Sourced by ZipRecruiter

KRG Technologies was founded with a simple motive of offering the clients exactly what they want, how they want and when they want. By leveraging for its clients its technological edge and right-sourcing advantage, KRG in a short period of time has grown to become one of the most trusted strategic technology partners. Treating every client as the top priority, we customize our solutions and services to align with the unique needs of each client. Headquartered in Valencia, California, KRG employs a unique global delivery platform to minister its offerings spanning from application development and maintenance to business process reengineering. With years of hands-on domain experience and international presence, we offer state-of-the-art solutions backed by our follow-the-sun service model in the most cost effective manner. We value our clientele for the trust reposed in us and our clientele admire us for our personalized approach and deep commitment to their success. Our biggest strength lies in technical expertise of our team and individual competency of our employees, which enables us to be the most befitting solution provider.

Industry

It services

Company size

201 - 500 Employees

Headquarters location

Valencia, CA, US

Year founded

2003

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