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Provider Payment Appeal Analyst Jobs (NOW HIRING)

HealthX Ventures

Provider Payment Specialist

Provider Payment Specialist Self Fund Health is seeking a detail-oriented and analytical Provider Payment Specialist to support the operational and financial processes that help make our provider ...

Integrated Resources

Appeal Analyst RN I

Pennington, NJ · On-site

$40 - $42/hr

Appeal Analyst RN I Job Location: Hopewell, NJ Job Duration: 6 Months (possibility of extension ... provides guidance and education to stakeholders regarding ICD-10-CM coding, DRG assignment, payment ...

US Tech Solutions

Appeal Analyst RN #

Hopewell, NJ · On-site

$42 - $45/hr

Appeal Analyst RN who will train new hire in the clinical role to complete Utilization Management ... Prepares and presents appeals to Provider Appeals Committee in accordance with criteria including ...

AA2IT

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Complaint and Appeal Analyst

Sturtevant, WI · On-site

$24 - $26/hr

Provide technical support and remote troubleshooting guidance as needed. * Independently review ... Conduct statistical analysis of complaint trends. * Support training program by training users on ...

Quartz

$80 - $100/hr

Review and respond to escalated provider payment integrity policy appeals. Qualifications ... Proficient in data analytic tools * Comfortable interfacing with providers at the executive level

Paradigm

$60 - $80/hr

Analyze payment activity trends and provide reporting related to payment accuracy, aging, rejection trends, reconciliation findings, and resolution timelines * Identify operational risks, process ...

Med-Hire

Medical Biller

Atlanta, GA

$17.50 - $22.50/hr

Daily submission of electronic claims and tracking of all claims to ensure prompt payment Appeal ... Research, analyze and resolve outstanding customer/insurance balances Locate and notify insurance ...

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All JobsProvider Payment Appeal Analyst Jobs

Provider Payment Appeal Analyst information

See salary details

$37K

$71.2K

$110.5K

How much do provider payment appeal analyst jobs pay per year?

As of Sep 9, 2026, the average yearly pay for provider payment appeal analyst in the United States is $71,216.00, according to ZipRecruiter salary data. Most workers in this role earn between $44,000.00 and $87,000.00 per year, depending on experience, location, and employer.

What does a provider payment appeal analyst do?

A Provider Payment Appeal Analyst is responsible for reviewing, analyzing, and processing appeals submitted by healthcare providers regarding denied or underpaid insurance claims. They examine claim documentation, apply relevant policies and guidelines, and communicate with providers and insurance companies to resolve disputes. Their goal is to ensure accurate and fair payment for healthcare services, while maintaining compliance with regulations and organizational procedures.

What are some typical challenges a provider payment appeal analyst faces when reviewing complex claim denials?

Provider Payment Appeal Analysts often encounter challenges such as interpreting nuanced payer policies, navigating incomplete or ambiguous documentation, and managing high volumes of appeals within tight deadlines. Analysts must balance attention to detail with efficiency, ensuring appeals are both accurate and compliant with regulatory standards. Collaborating with providers, billing teams, and insurance representatives to clarify discrepancies is also a key part of overcoming these challenges and achieving successful appeal outcomes.

What are the key skills and qualifications needed to thrive as a provider payment appeal analyst, and why are they important?

To thrive as a Provider Payment Appeal Analyst, you need a strong understanding of healthcare billing, claims processing, and medical terminology, usually supported by a degree in healthcare administration or related experience. Familiarity with claims management systems, Medicare/Medicaid guidelines, and proficiency in Microsoft Excel are often required, along with certifications like CPC or CPMA being advantageous. Attention to detail, analytical thinking, and effective written communication are crucial soft skills for reviewing complex appeals and interacting with providers. These skills ensure accurate resolution of payment disputes, compliance with regulations, and efficient workflow in healthcare reimbursement processes.

What is the difference between Provider Payment Appeal Analyst vs Claims Processor?

AspectProvider Payment Appeal AnalystClaims Processor
CredentialsTypically requires knowledge of healthcare billing, insurance policies, and sometimes certifications like CPC or CCSOften requires basic knowledge of insurance claims, with less emphasis on certifications
Work EnvironmentHealthcare insurance companies, hospitals, or third-party administratorsInsurance companies, healthcare providers, or billing offices
Job FocusReviewing and resolving denied or disputed claims, appealing payment decisionsProcessing incoming claims, data entry, and initial claim review

The Provider Payment Appeal Analyst primarily focuses on reviewing and appealing denied claims, requiring specialized knowledge of healthcare billing and insurance policies. In contrast, Claims Processors handle the initial processing of claims, often with less emphasis on appeals or complex billing issues. Both roles are essential in healthcare reimbursement but differ in scope and responsibilities.

What cities are hiring for Provider Payment Appeal Analyst jobs?

Cities with the most Provider Payment Appeal Analyst job openings:

What states have the most Provider Payment Appeal Analyst jobs?

States with the most job openings for Provider Payment Appeal Analyst jobs include:

What are popular job titles related to Provider Payment Appeal Analyst jobs?

For Provider Payment Appeal Analyst jobs, the most frequently searched job titles are:

Infographic showing various Provider Payment Appeal Analyst job openings in the United States as of September 2026, with employment types broken down into 80% Full Time, 10% Part Time, and 10% Contract. Highlights an 65% In-person, 10% Hybrid, and 25% Remote job distribution, with an average salary of $71,216 per year, or $34.2 per hour.

Provider Payment Specialist

Remote

HealthX Ventures
Investment Clubs and Venture Capital Companies • 1 - 10 employees
Learn more about HealthX Venturesexternal

Other

Posted 4 days ago

Job description

Provider Payment Specialist

Self Fund Health is seeking a detail-oriented and analytical Provider Payment Specialist to support the operational and financial processes that help make our provider payment model successful. This role is responsible for obtaining good faith estimates, analyzing healthcare costs across in-network and cash-based providers, generating member cash cards, educating members on documentation and receipt submission requirements, and ensuring provider invoices are accurate and complete.

This role works closely with nurse navigators by providing cost analysis, payment support, and pricing information that helps inform member recommendations. This position does not perform care navigation directly, but serves as an important operational partner to the care navigation team.

This is an ideal opportunity for someone who is highly organized, comfortable working across provider billing and payment workflows, and passionate about helping improve the affordability and accessibility of healthcare.

Key Responsibilities

  • Work with provider billing teams to obtain good faith estimates for scheduled services.
  • Complete healthcare cost analyses for in-network and cash-based providers to support cost-effective provider selection.
  • Generate cash cards for members receiving approved services.
  • Educate members on how to use cash cards, what documentation is required, and how to upload receipts.
  • Partner with nurse navigators by providing timely cost information and operational support related to provider pricing and payment options.
  • Support internal teams in identifying the most cost-effective provider and payment options for members.
  • Review provider invoices for accuracy, completeness, and alignment with agreed pricing or estimates.
  • Investigate and resolve invoice discrepancies with provider offices and internal stakeholders.
  • Maintain accurate documentation related to estimates, invoices, receipts, and payments.
  • Contribute to process improvements that increase accuracy, efficiency, and scalability across provider payment operations.

Qualifications

Required

  • 2+ years of experience in healthcare operations, provider billing, revenue cycle, claims, payment administration, or a related field.
  • Strong analytical skills with the ability to compare provider costs and evaluate pricing options.
  • High attention to detail and accuracy in reviewing invoices, estimates, and documentation.
  • Strong written and verbal communication skills.
  • Ability to explain payment processes and documentation requirements clearly to members and provider offices.
  • Strong organizational skills and the ability to manage multiple workflows at once.
  • Proficiency in Excel or Google Sheets.

Preferred

  • Experience working with provider billing teams, healthcare payment workflows, or reimbursement operations.
  • Familiarity with good faith estimates, cash-pay arrangements, and receipt/documentation requirements.
  • Experience working cross-functionally with care navigation, provider engagement, or healthcare cost containment teams.
  • Experience in a fast-paced, growth-stage healthcare environment

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