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Medical Claims Analyst Jobs (NOW HIRING)

Robert Half

Medical Claims Analyst

Cleveland, OH · On-site

$27 - $35/hr

We are looking for an experienced Medical Claims Analyst to support Medicaid billing operations for a long-term contract opportunity in Cleveland, Ohio. This position focuses on claims-related ...

KeyStaff

Billing & Claims Analyst

Pompano Beach, FL

$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 ...

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

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 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 ...

Healthcare Highways, Inc.

Be Seen First

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.

Delaware Claims

Claims Analyst

Wilmington, DE · On-site

$52K/yr

... package includes medical, dental, vision, disability, parking stipend, 401-K, generous PTO ... Duties Analyze Claims in accordance with Review procedures. Take a proactive approach to claims ...

Delaware Claims

Claims Analyst

Wilmington, DE · On-site

$52K/yr

... package includes medical, dental, vision, disability, parking stipend, 401-K, generous PTO ... Duties Analyze Claims in accordance with Review procedures. Take a proactive approach to claims ...

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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 Aug 23, 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 August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $52,237 per year, or $25.1 per hour.

Medical Claims Analyst

Robert Half

Cleveland, OH • On-site

$27 - $35/hr

Temporary

Posted 16 days ago

Job description

We are looking for an experienced Medical Claims Analyst to support Medicaid billing operations for a long-term contract opportunity in Cleveland, Ohio. This position focuses on claims-related analysis, authorization workflows, and eligibility validation to help maintain accurate billing and reimbursement activity. The ideal candidate brings strong Medicaid expertise, confidence working with 270/271 transactions, and the ability to interpret reporting data in a fast-paced onsite environment.
Responsibilities:
• Review Medicaid-related claims activity and analyze billing information to support timely and accurate reimbursement.
• Manage pre-authorization and payer authorization processes, ensuring required approvals are secured before services are billed.
• Generate, interpret, and reconcile 270/271 eligibility and response reports to confirm coverage and support service reauthorization.
• Examine post-submission billing results to identify claim issues, track denials or rejections, and recommend corrective action.
• Validate member eligibility data for Medicaid billing and maintain accurate supporting documentation for claims processing.
• Assist with reauthorization workflows for ongoing services by using eligibility and transaction data to confirm continued coverage.
• Provide reporting support related to Medicaid billing activity and help organize information needed for limited grant invoicing tasks.
• Work closely with internal stakeholders to resolve billing discrepancies and improve the accuracy of claims-related processes.• 5+ years of experience in medical claims, medical billing, or Medicaid-focused revenue cycle work.
• Strong hands-on knowledge of Medicaid billing regulations, claims workflows, and authorization requirements.
• Demonstrated experience working with 270/271 transactions, eligibility reporting, and service reauthorization processes.
• Ability to investigate claim denials, rejected claims, and other reimbursement issues with a high level of accuracy.
• Proficiency in Excel, including PivotTables and VLOOKUP for reporting and data analysis.
• Background in behavioral health billing or claims support is strongly preferred.
• Strong analytical, organizational, and communication skills in an onsite team environment.
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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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