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Medical Claims Analyst Jobs (NOW HIRING)

Robert Half

Medical Claims Analyst

Princeton, NJ · On-site

$72K - $93K/yr

We are looking for a Medical Claims Analyst to join a detail-oriented team, supporting workers' compensation matters through careful medical record analysis. This position is well suited for someone ...

Chubb

ESIS Medical Claims Analyst

Southfield, MI

ESIS is seeking an experienced workers' compensation Medical Claims Analyst for the Southfield MI. The person in this role will handle and maintain Medical Only Workers' Compensation claims and file ...

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 ...

Real Soft Inc

Be Seen First

Medical Claims Specialist

Minneapolis, MN · On-site

$28.16/hr

Analyze, investigate, and process complex Critical Illness claims accurately and timely ... Review medical records and clinical documentation to validate eligibility and benefit conditions.

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 ...

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

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

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 ...

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All JobsMedical Claims Analyst Jobs

Medical Claims Analyst information

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$15

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How much do medical claims analyst jobs pay per hour?

As of Jul 13, 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 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 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 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.

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Medical Claims Analyst jobs near you
Medical Claims Analyst

Medical Claims Analyst

Robert Half

Princeton, NJ • On-site

$72K - $93K/yr

Full-time

Medical, Retirement, PTO

Posted 4 days ago

Job description

We are looking for a Medical Claims Analyst to join a detail-oriented team, supporting workers’ compensation matters through careful medical record analysis. This position is well suited for someone with clinical knowledge who enjoys evaluating treatment details, identifying relevant case information, and helping legal professionals understand complex medical documentation. The role offers an in-office environment with the opportunity to contribute to case preparation while building knowledge of legal workflows.

Salary:

$35 - $45 / per hour

Benefits:

MDV, PTO, 401k

Responsibilities:

• Examine medical charts, provider notes, and treatment documentation to create clear case summaries for workers’ compensation matters.

• Analyze injuries, diagnoses, procedures, and recovery progress to outline accurate medical timelines and key developments.

• Contact healthcare offices and providers to request records, confirm missing information, and resolve documentation questions.

• Work closely with attorneys by explaining medical details and highlighting information that may affect case strategy.

• Maintain organized case materials by tracking incoming records, updating files, and ensuring documentation is easy to retrieve.

• Prepare medical overview materials that support hearings, case reviews, and other legal proceedings.

• Assist with administrative case support, including basic legal documentation and coordination tasks, with training provided as needed.

• Experience in a healthcare-related role such as nursing, medical assisting, therapy support, or a similar clinical setting is preferred.
• Working knowledge of medical terminology, common treatment methods, and healthcare documentation practices.
• Experience reviewing medical records, patient histories, or related clinical documents with a high level of accuracy.
• Strong attention to detail and the ability to manage multiple files, deadlines, and document requests effectively.
• Comfort using office systems and learning new tools or workflows in a workplace setting.
• Clear written and verbal communication skills for interacting with providers and collaborating with legal staff.
• Prior legal experience is not required; candidates should be open to training and learning workers’ compensation processes.
• Exposure to workers’ compensation, personal injury matters, medical billing, or insurance claims is a plus.
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About Robert Half

Sourced by ZipRecruiter

Founded in 1948, Robert Half pioneered the idea of professional talent solutions to connect opportunities at great companies with highly skilled job seekers. As business needs changed, we evolved to offer specialized talent solutions for finance and accounting, technology, administrative and customer support, creative and marketing, and legal fields. In 2002, we introduced our subsidiary, Protiviti, a global independent risk consulting and internal audit service, to support companies as they faced more strategic business challenges.

Industry

Recruiting and staffing services

Company size

10,000+ Employees

Headquarters location

San Ramon, CA, US

Year founded

1948

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