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Medicare Claims Analyst Jobs (NOW HIRING)

Ovationhealthcare

Specialist, Medicare

Prepares and submits appeals for denied claims, including supporting documentation. * Monitor and analyze aging reports to prioritize follow-up actions for overdue Medicare accounts, ensuring timely ...

Ovation Healthcare

Specialist, Medicare

Prepares and submits appeals for denied claims, including supporting documentation. * Monitor and analyze aging reports to prioritize follow-up actions for overdue Medicare accounts, ensuring timely ...

Wipro Limited

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.

SIHO HOLDING INC

Claims Analyst

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 ...

SIHO HOLDING INC

Claims Analyst

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 ...

SIHO Insurance Services

Claims Analyst

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 ...

Barrow Wise Consulting

Medicare Analyst

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 ...

Healthcare Support Staffing

Claims Analyst

Austin, TX

$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 ...

Elevate Patient Financial Solutions

Medicare Specialist

$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 ...

Corrohealth

Medicare Specialist

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 ...

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Medicare Claims Analyst information

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How much do medicare claims analyst jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for medicare claims analyst in the United States is $27.39, according to ZipRecruiter salary data. Most workers in this role earn between $20.19 and $31.49 per hour, depending on experience, location, and employer.

What does a Medicare Claims Analyst do?

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.

What skills and qualifications are needed to be a Medicare Claims Analyst?

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.

What challenges do Medicare Claims Analysts face in their day-to-day work?

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.

How much do Medicare Claims Analysts make in the US?

Medicare Claims Analysts in the US typically earn an average salary ranging from $45,000 to $65,000 per year, depending on experience, location, and certifications. Entry-level positions may start lower, while experienced analysts with specialized skills can earn higher salaries. The role often requires knowledge of healthcare billing, claims processing, and familiarity with Medicare policies.

How to become a Medicare Claims Analyst?

To become a Medicare Claims Analyst, candidates typically need a bachelor's degree in health administration, healthcare management, or a related field. Relevant skills include knowledge of Medicare policies, claims processing, and data analysis, often supported by certifications such as the Certified Professional Coder (CPC) or Certified Claims Professional (CCP). Gaining experience through internships or entry-level roles in healthcare billing or claims processing can also be beneficial.

Is claims processing a stressful job?

Medicare Claims Analysts often work in a fast-paced environment where accuracy and attention to detail are essential, which can lead to stress, especially during high-volume periods or when resolving complex claims. The job typically involves working with claims management software and adhering to strict deadlines, but stress levels vary depending on workload and organizational support.
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Cities with the most Medicare Claims Analyst job openings:

What states have the most Medicare Claims Analyst jobs?

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What job categories do people searching Medicare Claims Analyst jobs look for?

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Medicare Claims Analyst jobs near you
Infographic showing various Medicare Claims Analyst job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 76% In-person, and 24% Remote job distribution, with an average salary of $56,974 per year, or $27.4 per hour.

Specialist, Medicare

Ovationhealthcare

Remote

Full-time

Re-posted 7 days ago

Job description

Welcome to Ovation Healthcare!

At Ovation Healthcare (formerly QHR Health), we've been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions.

The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare's vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior.

We're looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare, you will have the opportunity to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork.

Ovation Healthcare's corporate headquarters is located in Brentwood, TN. For more information, visitwww.ovationhc.com.

Summary:

The Medicare Specialist is responsible for managing the billing and collection processes for Medicare patients, ensuring compliance with Medicare policies and regulations, and following up on unpaid Medicare claims. This role involves processing Medicare claims, managing accounts receivable, addressing patient inquiries, and working closely with Medicare representatives to resolve billing issues.

Duties and Responsibilities:

  • Prepare and submit accurate Medicare claims for patient services, ensuring compliance with Medicare guidelines and regulations. Utilizes DDE, CWF, and other tools to identify, track and follow up on unpaid or denied Medicare claims, identifying issues and working to resolve any billing discrepancies with Medicare or patients.

  • Review patient accounts and reconcile payments with Medicare remittance advice, ensuring all payments are posted correctly and outstanding balances are addressed. Communicate with patients regarding their Medicare coverage, billing questions, payment options, and any unpaid balances.

  • Investigate and resolve issues related to denied or underpaid Medicare claims, working with Medicare representatives and internal departments to ensure accurate reimbursement. Prepares and submits appeals for denied claims, including supporting documentation.

  • Monitor and analyze aging reports to prioritize follow-up actions for overdue Medicare accounts, ensuring timely resolution. Ensure all billing and collection practices are compliant with Medicare regulations, HIPAA, and company policies. Identifies potential compliance risks and recommends corrective action. Maintains accurate records of all Medicare claims, payments, communications, and follow-up activities, ensuring proper documentation in the patient account system.

  • Identify and resolve Medicare credit balances and may assist with preparation of quarterly Medicare credit balance report. Request offset to future payments in DDE.

  • Work with internal departments, such as coding, finance, etc. to review diagnosis, CPT code, etc. to resolve claim edit issues.

  • Prepare, submit, and follow up on redetermination appeals to Medicare

Knowledge, Skills, and Abilities:

  • Ability to analyze complex data, identify patterns, and draw accurate conclusions.

  • High level of accuracy in reviewing medical records and billing data.

  • Ability to analyze claim data, identify billing errors, and troubleshoot complex claim issues.

  • In-depth knowledge of Medicare billing codes, guidelines, and regulations. Familiarity with electronic health record (EHR) systems, billing software, and remittance advice processing and DDE. Strong communication skills, with the ability to explain Medicare billing details and resolve patient concerns effectively.

  • Ability to handle sensitive information and maintain confidentiality in accordance with HIPAA regulations. Detail-oriented with strong organizational skills and the ability to manage multiple accounts simultaneously. Problem-solving abilities, particularly with regard to billing discrepancies and denied claims.

Work Experience, Education, and Certifications:

  • Experience utilizing Payer portals, DDE and client systems

  • 3-5 years of hospital Business Office billing and follow-up experience as a Medicare representative. Medical Terminology, ICD-10, CPT and DRG knowledge a preferred, knowledge of third-party Insurance payer guidelines

  • High school diploma or equivalent

Working Conditions:

Work from home and remote location with a stable internet connection, a quiet and dedicated workspace free of distractions, and access to necessary office equipment. The ability to have daily communication with team members, management, and clients through email, phone calls, video meetings and other collaborative tools. Primarily requires sitting at a desk for extended period. Proper lighting and ergonomics shole be maintained to reduce eye strain.

100% Remote

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