Claims Analyst
Columbus, IN · On-site
... claim. Analyst must also assist in determining cause for manual intervention, then assist in ... Brief Description of Duties: * Review incoming medical, pharmacy vision and dental claims
Claims Analyst
Columbus, IN · On-site
... claim. Analyst must also assist in determining cause for manual intervention, then assist in ... Brief Description of Duties: * Review incoming medical, pharmacy vision and dental claims
... claim medical review for Commercial, FEP and Medicare Advantage Plans. * This position assists in determining acceptable medical risk to the organization by analyzing medical information of ...
... claim medical review for Commercial, FEP and Medicare Advantage Plans. * This position assists in determining acceptable medical risk to the organization by analyzing medical information of ...
Claims Compliance Analyst
East Longmeadow, MA · On-site
$60K - $70K/yr
... the submitted medical treatment and investigating the coverage terms. * Maintain a strong ... Review all claim-related compliance reports to ensure accuracy. * Scrub pay-related reports to ...
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Claims Compliance Analyst
East Longmeadow, MA · On-site
$60K - $70K/yr
... the submitted medical treatment and investigating the coverage terms. * Maintain a strong ... Review all claim-related compliance reports to ensure accuracy. * Scrub pay-related reports to ...
Conduct and support claim investigations by gathering and reviewing incident reports, witness ... medical documentation, and other supporting evidence. * Monitor open claim inventory, identify ...
Conduct and support claim investigations by gathering and reviewing incident reports, witness ... medical documentation, and other supporting evidence. * Monitor open claim inventory, identify ...
Medical Review Specialist
Pensacola, FL · On-site
Review, analyze, and summarize medical records of varying length, complexity, and medical specialty. * Extract, organize, and document factual medical information in accordance with client-specific ...
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Medical Review Specialist
Pensacola, FL · On-site
Review, analyze, and summarize medical records of varying length, complexity, and medical specialty. * Extract, organize, and document factual medical information in accordance with client-specific ...
Conduct and support claim investigations by gathering and reviewing incident reports, witness ... medical documentation, and other supporting evidence. * Monitor open claim inventory, identify ...
Conduct and support claim investigations by gathering and reviewing incident reports, witness ... medical documentation, and other supporting evidence. * Monitor open claim inventory, identify ...
Medical Review Nurse III
Baltimore, MD · On-site +1
$80K - $95K/yr
Perform automated and complex medical record and claim reviews to make coverage determinations ... Compile a report of analysis and recommendations to submit to CMS. * Perform New Issue Quality ...
Medical Review Nurse III
Baltimore, MD · On-site +1
$80K - $95K/yr
Perform automated and complex medical record and claim reviews to make coverage determinations ... Compile a report of analysis and recommendations to submit to CMS. * Perform New Issue Quality ...
Claims Analyst
Columbus, IN · On-site
... claim. Analyst must also assist in determining cause for manual intervention, then assist in ... Brief Description of Duties: * Review incoming medical, pharmacy vision and dental claims
Claims Analyst
Columbus, IN · On-site
... claim. Analyst must also assist in determining cause for manual intervention, then assist in ... Brief Description of Duties: * Review incoming medical, pharmacy vision and dental claims
CPC Denials Escalation Analyst
West Long Branch, NJ · On-site
$30 - $34/hr
... claim escalations, contribute to denial-prevention strategies, perform chart reviews, and ensure ... Medical, Dental, Vision, Life Insurance, Voluntary, Time-Off Benefits, EAP, 401K and Commuter ...
CPC Denials Escalation Analyst
West Long Branch, NJ · On-site
$30 - $34/hr
... claim escalations, contribute to denial-prevention strategies, perform chart reviews, and ensure ... Medical, Dental, Vision, Life Insurance, Voluntary, Time-Off Benefits, EAP, 401K and Commuter ...
Medicaid Medical Review RN (Medical Reviewer III)
$78K - $85K/yr
... claim was payable and if any signed of fraud, waste or abuse are noted * Knowledge of, and the ... Advance knowledge of medical terminology and experience in the analysis and processing of Medicare ...
Medicaid Medical Review RN (Medical Reviewer III)
$78K - $85K/yr
... claim was payable and if any signed of fraud, waste or abuse are noted * Knowledge of, and the ... Advance knowledge of medical terminology and experience in the analysis and processing of Medicare ...
Medicaid Medical Review RN (Medical Reviewer III)
$78K - $85K/yr
... claim was payable and if any signed of fraud, waste or abuse are noted * Knowledge of, and the ... Advance knowledge of medical terminology and experience in the analysis and processing of Medicare ...
Medicaid Medical Review RN (Medical Reviewer III)
$78K - $85K/yr
... claim was payable and if any signed of fraud, waste or abuse are noted * Knowledge of, and the ... Advance knowledge of medical terminology and experience in the analysis and processing of Medicare ...
$78K - $85K/yr
... claim was payable and if any signed of fraud, waste or abuse are noted * Knowledge of, and the ... Advance knowledge of medical terminology and experience in the analysis and processing of Medicare ...
$78K - $85K/yr
... claim was payable and if any signed of fraud, waste or abuse are noted * Knowledge of, and the ... Advance knowledge of medical terminology and experience in the analysis and processing of Medicare ...
Perform automated and complex medical record and claim reviews to make coverage determinations ... Compile a report of analysis and recommendations to submit to CMS. * Perform New Issue Quality ...
Perform automated and complex medical record and claim reviews to make coverage determinations ... Compile a report of analysis and recommendations to submit to CMS. * Perform New Issue Quality ...
... claim meets these requirements. Primarily responsible for conducting clinical reviews of medical ... analysis efforts. Applies Medicare guidelines in making clinical determinations as to the ...
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... claim meets these requirements. Primarily responsible for conducting clinical reviews of medical ... analysis efforts. Applies Medicare guidelines in making clinical determinations as to the ...
Claims Analyst I - Remote
Parsippany, NJ · On-site
$65 - $70/hr
Prior Medicaid Claim processing experience with a Pharmaceutical and/or med Device company, state ... Review suspect claim records and determine if record should be disputed for payment. 20% * Resolve ...
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Claims Analyst I - Remote
Parsippany, NJ · On-site
$65 - $70/hr
Prior Medicaid Claim processing experience with a Pharmaceutical and/or med Device company, state ... Review suspect claim records and determine if record should be disputed for payment. 20% * Resolve ...
Senior Claims Analyst
Philadelphia, PA · On-site
$110K/yr
Clinical review of inpatient and outpatient medical claims * Read, understand, and analyze comprehensive medical records and itemized bills * Make and present claim resolution recommendations to ...
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Senior Claims Analyst
Philadelphia, PA · On-site
$110K/yr
Clinical review of inpatient and outpatient medical claims * Read, understand, and analyze comprehensive medical records and itemized bills * Make and present claim resolution recommendations to ...
Claims Analyst I
Parsippany, NJ · On-site
$50 - $70/hr
... med Device company , state and/or state agency or as Medicaid consultant or equivalent work ... Review suspect claim records and determines if record should be disputed for payment. 20% * Resolve ...
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Claims Analyst I
Parsippany, NJ · On-site
$50 - $70/hr
... med Device company , state and/or state agency or as Medicaid consultant or equivalent work ... Review suspect claim records and determines if record should be disputed for payment. 20% * Resolve ...
Sr Claims Analyst
$18.07 - $33.92/hr
In addition to these tasks, the Senior Claims Analyst is responsible for all of the same tasks as a Claim Analyst including the accurate adjudication and processing of medical, dental, vision, or ...
Sr Claims Analyst
$18.07 - $33.92/hr
In addition to these tasks, the Senior Claims Analyst is responsible for all of the same tasks as a Claim Analyst including the accurate adjudication and processing of medical, dental, vision, or ...
Responsibilities As a Medical Review Specialist V (Medical Reviewer V), you will review and analyze ... Completes summary report upon completion of the records review, summarizing claim determinations ...
Responsibilities As a Medical Review Specialist V (Medical Reviewer V), you will review and analyze ... Completes summary report upon completion of the records review, summarizing claim determinations ...
Prior Medicaid Claim processing experience with a Pharmaceutical and/or med Device company , state ... Review suspect claim records and determines if record should be disputed for payment.20% * Resolve ...
Quick apply
Prior Medicaid Claim processing experience with a Pharmaceutical and/or med Device company , state ... Review suspect claim records and determines if record should be disputed for payment.20% * Resolve ...
Medical Review Claim Analyst information
See salary details
$15.63 - $17.94
16% of jobs
$18.76 is the 25th percentile. Wages below this are outliers.
$17.94 - $20.26
26% of jobs
The median wage is $20.94 / hr.
$20.26 - $22.57
29% of jobs
$23.62 is the 75th percentile. Wages above this are outliers.
$22.57 - $24.89
11% of jobs
$24.89 - $27.21
5% of jobs
$27.21 - $29.52
1% of jobs
$29.52 - $31.84
1% of jobs
$31.84 - $34.16
4% of jobs
$34.16 - $36.47
1% of jobs
$36.47 - $38.79
4% of jobs
$38.79 - $41.11
2% of jobs
$15
$25
$41
How much do medical review claim analyst jobs pay per hour?
As of Sep 10, 2026, the average hourly pay for medical review 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.
What are popular job titles related to Medical Review Claim Analyst jobs?
For Medical Review Claim Analyst jobs, the most frequently searched job titles are:
Claims Analyst
Columbus, IN • On-site
SIHO HOLDING INC
Full-time
Medical, Dental, Vision
Re-posted 2 days ago
Job description
Job Title: Claims Analyst
Reports To: Supervisor of Claims
This is a non-exempt position responsible for reviewing, analyzing, and adjudicating non-routine health claims that could not be system adjudicated for payment. Analyst must research and interpret summary plan description language and make accurate determination for adjudication or denial of claim. Analyst must also assist in determining cause for manual intervention, then assist in writing logic and workflow automation for future claims.
Brief Description of Duties:
- Review incoming medical, pharmacy vision and dental claims
- Determine and apply appropriate health plan benefits and update claims for payment
- Ensure timely and accurate claims adjudication
- Follow company guidelines and policies for adjudicating claims and responding to members
- Act as a resource for questions, opportunities, and research issues for all internal and external customers
- Responsible for meeting performance measurement standards for productivity and accuracy
- Identify and resolve operational problems using defend processes, judgment, and expertise
- Provide feedback to team members regarding process improvement opportunities
- Asset with training and mentoring of new team members
- Resolve identified claims issues based on CCI edit repot to comply with CMS guidelines.
- Represent the department when needed for internal and external company meetings
- Complete special projects (including research) as assigned by Claims Supervisor or Director of Claims
- High level understanding of state and federal laws specific to health plan administration (HIPPA, ERISA, MHPAEA, ACA Mandates etc.)
- Develop and maintain statistical data as required
- Assist in departmental reporting
Minimum Skills Requirement:
- Post-secondary education or two years experience in a claims processing environment
- Experience in Medicare Advantage strongly preferred
- Excellent communications (oral and written) skills
- Intermediate skill levels in Microsoft Word, Excel, and Outlook preferred
- Ability to work at a self-directed pace in a changing, multi-task environment
- Detail oriented
- Professional appearance and presence
- Commitment to support and maintain confidentiality in conformance to HIPAA guidelines
Other:
- Confirmation of excellent attendance record in current or most recent job
- General knowledge and understanding of claims processing functions