Medicare BPO
Jefferson City, MO · On-site
Analyze and reconcile rejected claims daily, determining root causes and applying appropriate solutions. * Manually correct claims data when necessary to ensure compliance with Medicare requirements.
Jefferson City, MO · On-site
Analyze and reconcile rejected claims daily, determining root causes and applying appropriate solutions. * Manually correct claims data when necessary to ensure compliance with Medicare requirements.
Jefferson City, MO · On-site
Analyze and reconcile rejected claims daily, determining root causes and applying appropriate solutions. * Manually correct claims data when necessary to ensure compliance with Medicare requirements.
Nashville, TN · Hybrid
$17.50 - $23.25/hr
BlueCross BlueShield of South Carolina is seeking a full-time Medicare Claims Overpayment Claims ... The role includes analyzing payment data, verifying overpayments, and preparing correspondence with ...
Nashville, TN · Hybrid
$17.50 - $23.25/hr
BlueCross BlueShield of South Carolina is seeking a full-time Medicare Claims Overpayment Claims ... The role includes analyzing payment data, verifying overpayments, and preparing correspondence with ...
Nashville, TN · Hybrid
$17.50 - $23.25/hr
BlueCross BlueShield of South Carolina is seeking a full-time Medicare Claims Overpayment Claims ... The role includes analyzing payment data, verifying overpayments, and preparing correspondence with ...
Nashville, TN · Hybrid
$17.50 - $23.25/hr
BlueCross BlueShield of South Carolina is seeking a full-time Medicare Claims Overpayment Claims ... The role includes analyzing payment data, verifying overpayments, and preparing correspondence with ...
Scottsdale, AZ · On-site
Our Claims Analyst is essential to ensuring the Medicare Part D Compliance team is following CMS guidelines. The Claims Analyst is responsible for making sure the policies and procedures are simple ...
Scottsdale, AZ · On-site
Our Claims Analyst is essential to ensuring the Medicare Part D Compliance team is following CMS guidelines. The Claims Analyst is responsible for making sure the policies and procedures are simple ...
Huntington Beach, CA · On-site
$70K - $80K/yr
Verda Healthcare, Inc. is a Medicare Advantage Prescriptions Drug Plan (MAPD) organization ... We are looking for a Senior Claims Analyst to join our growing company with many internal ...
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Huntington Beach, CA · On-site
$70K - $80K/yr
Verda Healthcare, Inc. is a Medicare Advantage Prescriptions Drug Plan (MAPD) organization ... We are looking for a Senior Claims Analyst to join our growing company with many internal ...
Job Title: Claims Analyst Reports To: Supervisor of Claims This is a non-exempt position ... Experience in Medicare Advantage strongly preferred * Excellent communications (oral and written ...
Job Title: Claims Analyst Reports To: Supervisor of Claims This is a non-exempt position ... Experience in Medicare Advantage strongly preferred * Excellent communications (oral and written ...
Columbus, IN · On-site
Job Title: Claims Analyst Reports To: Supervisor of Claims This is a non-exempt position ... Experience in Medicare Advantage strongly preferred * Excellent communications (oral and written ...
Columbus, IN · On-site
Job Title: Claims Analyst Reports To: Supervisor of Claims This is a non-exempt position ... Experience in Medicare Advantage strongly preferred * Excellent communications (oral and written ...
Enabling our teams with leading technology allows analytics to guide our solutions and keeps us ... Edit and perform maintenance on Medicare claims. * Follow-up on billed claims in a timely and ...
Enabling our teams with leading technology allows analytics to guide our solutions and keeps us ... Edit and perform maintenance on Medicare claims. * Follow-up on billed claims in a timely and ...
Enabling our teams with leading technology allows analytics to guide our solutions and keeps us ... Edit and perform maintenance on Medicare claims. * Follow-up on billed claims in a timely and ...
Enabling our teams with leading technology allows analytics to guide our solutions and keeps us ... Edit and perform maintenance on Medicare claims. * Follow-up on billed claims in a timely and ...
MD · On-site
$70K - $90K/yr
Enhance claims management accuracy and compliance * Review and assess the current Medicare Part A & B, claiming policies, procedures, practices, and outcomes of each State-operated facility for ...
MD · On-site
$70K - $90K/yr
Enhance claims management accuracy and compliance * Review and assess the current Medicare Part A & B, claiming policies, procedures, practices, and outcomes of each State-operated facility for ...
Columbus, IN · On-site
Job Title: Claims Analyst Reports To: Supervisor of Claims This is a non-exempt position ... Experience in Medicare Advantage strongly preferred * Excellent communications (oral and written ...
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Columbus, IN · On-site
Job Title: Claims Analyst Reports To: Supervisor of Claims This is a non-exempt position ... Experience in Medicare Advantage strongly preferred * Excellent communications (oral and written ...
California, MO · On-site
$57 - $70/hr
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience Preferred: 5-7 years of related experience Experience working in a PACE, Medicare ...
California, MO · On-site
$57 - $70/hr
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience Preferred: 5-7 years of related experience Experience working in a PACE, Medicare ...
Los Angeles, CA · On-site
$57 - $70/hr
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience Preferred: 5-7 years of related experience Experience working in a PACE, Medicare ...
Los Angeles, CA · On-site
$57 - $70/hr
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience Preferred: 5-7 years of related experience Experience working in a PACE, Medicare ...
Philadelphia, PA · On-site
$110K/yr
Manage ad hoc Medicare pricing using APC * Clinical review of inpatient and outpatient medical claims * Read, understand, and analyze comprehensive medical records and itemized bills * Make and ...
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Philadelphia, PA · On-site
$110K/yr
Manage ad hoc Medicare pricing using APC * Clinical review of inpatient and outpatient medical claims * Read, understand, and analyze comprehensive medical records and itemized bills * Make and ...
Los Angeles, CA · On-site
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience working in a PACE, Medicare Advantage, or Medi-Cal managed-care environment.
Los Angeles, CA · On-site
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience working in a PACE, Medicare Advantage, or Medi-Cal managed-care environment.
$22.75 - $28.50/hr
Job Summary As a Medicare Specialist, you will be instrumental in helping resolve aged medical ... Develops a solid understanding of assigned client processes in order to review and analyze claims ...
$22.75 - $28.50/hr
Job Summary As a Medicare Specialist, you will be instrumental in helping resolve aged medical ... Develops a solid understanding of assigned client processes in order to review and analyze claims ...
Los Angeles, CA · On-site
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience working in a PACE, Medicare Advantage, or Medi-Cal managed-care environment.
Los Angeles, CA · On-site
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience working in a PACE, Medicare Advantage, or Medi-Cal managed-care environment.
$57 - $70/hr
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience Preferred: 5-7 years of related experience Experience working in a PACE, Medicare ...
$57 - $70/hr
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience Preferred: 5-7 years of related experience Experience working in a PACE, Medicare ...
Austin, TX · On-site
$22 - $24/hr
Are you an experienced Claims Analyst/Examiner looking for a new opportunity with a prestigious ... knowledge Medicaid, Medicare Requirements Strongly prefer Managed Care experience Preferred ...
Austin, TX · On-site
$22 - $24/hr
Are you an experienced Claims Analyst/Examiner looking for a new opportunity with a prestigious ... knowledge Medicaid, Medicare Requirements Strongly prefer Managed Care experience Preferred ...
Compton, CA · On-site
$63 - $76/hr
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience Preferred:5-7 years of related experienceExperience working in a PACE, Medicare ...
Compton, CA · On-site
$63 - $76/hr
The Claims Analyst is responsible for the accurate, timely, and compliant processing and ... Experience Preferred:5-7 years of related experienceExperience working in a PACE, Medicare ...
$14.66 - $18.05
14% of jobs
$20.07 is the 25th percentile. Wages below this are outliers.
$18.05 - $21.44
19% of jobs
The median wage is $23.67 / hr.
$21.44 - $24.83
26% of jobs
$24.83 - $28.21
9% of jobs
$29.98 is the 75th percentile. Wages above this are outliers.
$28.21 - $31.60
13% of jobs
$31.60 - $34.99
11% of jobs
$34.99 - $38.37
2% of jobs
$38.37 - $41.76
2% of jobs
$41.76 - $45.15
1% of jobs
$45.15 - $48.54
2% of jobs
$48.54 - $51.92
1% of jobs
$14
$27
$51
A Medicare Claims Analyst reviews, processes, and evaluates Medicare claims to ensure they comply with government regulations and payer policies. They analyze medical records, verify patient eligibility, and assess claim accuracy to prevent fraud or errors. Additionally, they communicate with healthcare providers, insurance companies, and beneficiaries to resolve claim disputes or discrepancies. Their role helps ensure timely and accurate reimbursements while maintaining compliance with Medicare guidelines.
To thrive as a Medicare Claims Analyst, you need strong analytical skills, a solid understanding of medical billing and coding, and familiarity with Medicare regulations, often supported by a relevant degree or certification such as Certified Professional Coder (CPC). Experience with claims management software, electronic health records (EHRs), and Medicare processing systems is typically required. Attention to detail, critical thinking, and clear communication are standout soft skills in this field. These capabilities are crucial to accurately processing claims, ensuring compliance, and helping healthcare organizations receive proper reimbursements.
Medicare Claims Analysts often encounter complex or ambiguous claims that require thorough investigation and careful interpretation of Medicare guidelines. Keeping up-to-date with frequent policy changes and varying payer requirements can be challenging and demands a high level of adaptability and continuous learning. The role may also involve managing a significant workload with tight deadlines, requiring strong organizational skills. However, working with medical, billing, and compliance teams provides collaborative opportunities and support, helping analysts address these challenges efficiently.
Cities with the most Medicare Claims Analyst job openings:
States with the most job openings for Medicare Claims Analyst jobs include:
The top searched job categories for Medicare Claims Analyst jobs are:

Full-time
Medical, Dental, Vision, PTO
Re-posted 10 days ago
Accurately enter Medicare claims data including patient, insurance, and billing information into designated systems.
Analyze and reconcile rejected claims daily, determining root causes and applying appropriate solutions.
Conduct thorough investigations into escalated claims issues to provide timely resolutions.
7.2
Based on 28 frontline employees who took The Breakroom Quiz
138th of 226 rated it services
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5,001 - 10,000 Employees
Doddakannelli, Bengaluru, IN