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Medical Claims Analyst Ii Jobs (NOW HIRING)

Searhc

Medical Claims Analyst

Juneau, AK · On-site

$31.83 - $44.56/hr

Pay Range:$31.83 - $44.56 The Medical Claims Analyst is responsible for supporting the accuracy ... Experience Required * 2 years of data entry experience with basic knowledge of accounts payable ...

CornerStone Staffing

Medical Claims Analyst

Dallas, TX · On-site

$19/hr

Medical Claims Analyst Location Dallas, TX 75243 | Onsite Compensation & Schedule * $19.00/hour ... Excellent job stability * 2-3 years of experience in a medical office, healthcare administrative ...

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 ...

Network Health, Inc

Claims Analyst II

Menasha, WI · On-site +1

We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role ... Certificate of Coverage, established medical policies and procedures, and plan benefit ...

Network Health

Claims Analyst II

Menasha, WI · On-site +1

We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role ... Certificate of Coverage, established medical policies and procedures, and plan benefit ...

Network Health

Claims Analyst II

Brookfield, WI · On-site +1

We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role ... Certificate of Coverage, established medical policies and procedures, and plan benefit ...

Integrated Resources INC

Claims Analyst

Syracuse, NY

Looking for medical claims experience for these position. * Top Three: Claims knowledge, efficient ... Required Experience: 0-2 years of claims processing with advancement to auditing / claims analysis ...

Network Health, Inc

Claims Analyst II

Brookfield, WI · On-site +1

We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role ... Certificate of Coverage, established medical policies and procedures, and plan benefit ...

California State Jobs

Claims Officer

Fresno, CA · On-site

Job Title Claims Analyst II and Duties Under the direction of the Fresno Legal Office Claims Manager (Supervisor I) and/or the Deputy Chief Counsel in the Fresno Legal Office, the Claims Analyst II ...

Network Health WI

Claims Analyst II

Menasha, WI · On-site

We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role ... Certificate of Coverage, established medical policies and procedures, and plan benefit ...

Towne Park, LLC

Claims Analyst II

Plymouth Meeting, PA · On-site

$62K - $68K/yr

The Claims Analyst II will perform a range of functions around the claims oversight and ... Employees are eligible to enroll in medical, dental, and vision insurance, accident insurance ...

Towne Park

$62K - $68K/yr

The Claims Analyst II will perform a range of functions around the claims oversight and ... Employees are eligible to enroll in medical, dental, and vision insurance, accident insurance ...

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 ...

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Medical Claims Analyst Ii information

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$15

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$41

How much do medical claims analyst ii jobs pay per hour?

As of Aug 25, 2026, the average hourly pay for medical claims analyst ii 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 II do?

A Medical Claims Analyst II is responsible for reviewing, analyzing, and processing medical insurance claims to determine their validity and ensure compliance with policy guidelines. They investigate discrepancies, verify patient and provider information, and ensure that claims are coded and billed accurately. This role often requires knowledge of medical terminology, insurance regulations, and claims processing systems, as well as experience handling more complex or escalated cases compared to entry-level analysts. Additionally, a Medical Claims Analyst II may assist in training junior staff and identifying trends or issues in claims processing.

What are the key skills and qualifications needed to thrive as a Medical Claims Analyst II, and why are they important?

To thrive as a Medical Claims Analyst II, you typically need a solid understanding of healthcare billing, insurance policies, and claims processing, often supported by an associate’s or bachelor’s degree in a related field and relevant work experience. Familiarity with claims management software, ICD-10/CPT coding systems, and knowledge of HIPAA regulations are essential. Strong analytical thinking, attention to detail, and effective communication set top performers apart in this role. These skills ensure accurate claims adjudication, compliance with regulations, and efficient resolution of complex cases.

What are some common challenges faced by Medical Claims Analyst II professionals, and how can they be addressed?

Medical Claims Analyst II professionals often encounter challenges such as handling complex claims with incomplete documentation, navigating changing regulatory requirements, and managing a high volume of cases within tight deadlines. To address these, strong organizational skills, continuous training on policy updates, and effective communication with providers and team members are crucial. Leveraging advanced claims management software and collaborating closely with other departments can also help streamline the review process and ensure accurate adjudication.
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Medical Claims Analyst Ii jobs near you
Infographic showing various Medical Claims Analyst Ii 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

Searhc

Juneau, AK • On-site

$31.83 - $44.56/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 5 days ago. Applications are no longer accepted.

Job description

Pay Range:

Pay Range:$31.83 - $44.56 The Medical Claims Analyst is responsible for supporting the accuracy, completeness, and compliance of medical claims processing and related Purchased/Referred Care (PRC) activities across the organization. This role performs claims review and processing, eligibility verification, referral validation, payment research, system administration, workflow support, and data integrity monitoring to ensure authorized services are processed accurately and timely. The position partners with PRC leadership, Finance, providers, internal departments, and external vendors to resolve complex claims issues, support reporting needs, improve claims processing workflows, and strengthen operational performance. Additionally, the role supports training, special projects, system upgrades, audit preparation, policy updates, and process improvement initiatives that advance PRC program compliance, provider communication, and financial decision-making.

SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.

Working at SEARHC is more than a job, it's a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more.

Key Essential Functions and Accountabilities of the Job

  • Performs all duties of the Medical Claims Specialist role, including review, screening, eligibility verification, alternate health resource verification, referral validation, claim processing, claims research, customer service, and interpretation of PRC Program regulations, policies, and procedures for internal and external customers.

  • Serves as the system administrator for the PRC claims processing platform, including user access coordination, system configuration support, workflow maintenance, issue tracking, testing, troubleshooting, and coordination with internal departments and external vendors as needed.

  • Maintains data integrity within the claims processing system by monitoring claim data, validating system outputs, supporting timely correction of errors, and identifying opportunities to improve accuracy, efficiency, and consistency in claims processing workflows.

  • Develops and supports training for providers, PRC staff, internal departments, and other key stakeholders on claims submission requirements, claims status processes, system workflows, documentation expectations, and applicable PRC policies and procedures.

  • Supports reporting projects for finance leadership and the executive team by gathering, validating, analyzing, and summarizing claims data, utilization trends, outstanding liabilities, denial activity, payment status, and other information needed for operational, financial, and strategic decision-making.

  • Partners with PRC leadership, Finance, providers, and other stakeholders to resolve complex claims issues, improve claims processing workflows, support provider communication, and ensure accurate and timely payment of authorized services.

  • Assists with special projects, process improvement initiatives, system upgrades, audit support, policy updates, and other duties as assigned.

Additional Job Description

Education, Certifications, and Licenses Required

  • High school diploma or equivalent required.

  • Medical terminology course required or 1 year of documented experience in a medical field requiring consistent use of medical terminology.

  • Bachelors degree in health care administration, business, finance, information systems, or related field preferred.

Experience Required

  • 2 years of data entry experience with basic knowledge of accounts payable processing, MS Excel, and MS Word software applications.

  • 4 years of business, medical office, claims processing, revenue cycle, health care finance, or related experience OR an equivalent combination of education and experience.

  • Experience processing medical claims in a tribal health organization preferred.

  • Experience with claims processing systems, system administration, reporting, training, workflow support, or process improvement preferred.

  • Medical coding background preferred.

Knowledge of

  • State, federal, and tribal health care programs.

  • Medical insurance process.

  • PRC Program regulations, policies, and procedures.

  • ICD, CPT, revenue, and diagnosis coding.

  • Claims processing systems, data entry standards, workflow controls, and system integrity practices.

  • Basic reporting concepts, data validation, and financial or operational analysis.

Skills in

  • Interpreting state, federal, and tribal contract health care guidelines.

  • Research, problem solving, claims analysis, and issue resolution.

  • Using claims processing systems, MS Excel, MS Word, and related reporting tools.

  • Training, presenting information, and communicating technical or process information to providers, staff, and other stakeholders.

  • Oral/written interpersonal communication and excellent customer service skills.

Ability to

  • Ability to multitask and manage competing priorities.

  • Ability to enter, review, and analyze large volumes of data timely and accurately.

  • Ability to work independently with minimal supervision and exercise sound judgment in resolving claims and system-related issues.

  • Ability to support users, troubleshoot workflow issues, and coordinate system-related follow-up with internal and external stakeholders.

  • Ability to prepare clear, accurate, and timely reporting to support finance leadership and executive decision-making.

  • Ability to respond quickly in urgent situations with attention to detail.

Required Certifications:

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

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