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How much do remote claims recovery analyst jobs pay per hour?

As of Jun 7, 2026, the average hourly pay for remote claims recovery 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 are the key skills and qualifications needed to thrive as a Remote Claims Recovery Analyst, and why are they important?

To thrive as a Remote Claims Recovery Analyst, you need strong analytical skills, attention to detail, and a background in finance, healthcare, or insurance, often supported by a relevant degree or experience. Familiarity with claims management software, data analysis tools, and Excel is typically required, and knowledge of industry regulations or certifications like Certified Professional Coder (CPC) can be beneficial. Excellent communication, problem-solving, and organizational skills are crucial for collaborating with stakeholders and managing multiple recovery cases efficiently. These competencies ensure accurate claims resolution, maximize recoveries, and uphold compliance in a remote working environment.

What is a Remote Claims Recovery Analyst?

A Remote Claims Recovery Analyst is a professional who reviews, investigates, and processes insurance or healthcare claims to identify overpayments, errors, or discrepancies. They work remotely to recover funds owed to the organization by analyzing claim data, communicating with clients or providers, and ensuring compliance with regulations. This role typically involves using specialized software, collaborating with other departments, and providing detailed reports on recovery activities. Strong analytical skills, attention to detail, and knowledge of insurance or healthcare claims processes are essential for success in this position.

What is the difference between Remote Claims Recovery Analyst vs Remote Insurance Claims Adjuster?

AspectRemote Claims Recovery AnalystRemote Insurance Claims Adjuster
Required CredentialsClaims certification, insurance knowledgeAdjuster license, insurance certification
Work EnvironmentOffice or remote, claims departmentRemote or on-site, claims handling
Employer & IndustryInsurance companies, third-party administratorsInsurance carriers, independent agencies
Common Search & ComparisonClaims recovery, debt collectionClaims assessment, settlement

The Remote Claims Recovery Analyst primarily focuses on recovering owed funds through claims analysis and debt collection, often working with insurance companies or third-party agencies. In contrast, the Remote Insurance Claims Adjuster evaluates and settles insurance claims, handling damage assessments and policy coverage. While both roles require insurance knowledge and certifications, their core functions differ—recovery versus claims settlement. Understanding these distinctions helps job seekers find the role that best matches their skills and career goals.

What are some common challenges faced by Remote Claims Recovery Analysts, and how can they be managed effectively?

Remote Claims Recovery Analysts often encounter challenges such as navigating complex insurance policies, managing large volumes of claims, and coordinating with multiple stakeholders virtually. To manage these effectively, strong organizational skills and attention to detail are essential. Proactive communication with clients, colleagues, and third-party payers, along with staying current on industry regulations, helps ensure accurate and timely claim resolutions. Regular check-ins with your remote team and leveraging digital workflow tools can also improve efficiency and collaboration.
More about Remote Claims Recovery Analyst jobs
What cities are hiring for Remote Claims Recovery Analyst jobs? Cities with the most Remote Claims Recovery Analyst job openings:
What are the most commonly searched types of Claims Recovery Analyst jobs? The most popular types of Claims Recovery Analyst jobs are:
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What job categories do people searching Remote Claims Recovery Analyst jobs look for? The top searched job categories for Remote Claims Recovery Analyst jobs are:
Remote Claims Recovery Analyst jobs near you
Infographic showing various Remote Claims Recovery Analyst job openings in the United States as of May 2026, with employment types broken down into 83% Full Time, and 17% Contract. Highlights an 100% Remote job distribution, with an average salary of $56,974 per year, or $27.4 per hour.

Lead Overpayment Recovery Analyst, Payment Integrity - Health Plan (Remote)

Passport Health Plan by Molina Healthcare

Detroit, MI • Remote

Full-time

Posted 18 days ago

Job description

JOB DESCRIPTION Job Summary

Provides lead level analyst support for health plan payment integrity activities.  Partners with leaders and functional representatives to drive health plan financial performance through evaluation and execution of operational initiatives tied to payment integrity (PI) and provider claims accuracy.  Makes recommendations that inform decisions which contribute to health plan strategy, and acts as a trusted voice in assessing and assisting resolution of complex business challenges that impact cost-containment and regulatory compliance.

Essential Job Duties

Business Leadership & Operational Ownership
Assists with and executes projects and tasks to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits, post-payment datamining, and overpayment recovery, to improve encounter submissions, reduce general and administrative (G&A) expenses, and drive positive operational and financial outcomes for all payment integrity (PI) solutions.
Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment recovery initiatives to ensure health plan SAI targets are met.
Leads efforts to improve claim payment accuracy and financial performance without needing extensive oversight.
Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.
Serves as a thought partner to health plan leadership and provides well-reasoned recommendations that support short- and long-term business goals.
Partners with the network team to communicate recovery projects to ensure provider relations is informed and able to respond to provider inquiries.

  • Analyze data to identify and develop new recovery opportunities
    • Analyze data from Payment Integrity and Vendors against contracts, billing, and processing guidelines
    • Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.
    • Conduct peer reviews of recovery concepts and offer recommendations for logical improvements; assist team members in their analysis of data sets and trends.
  • Responsible for documenting policies and procedures related to concept approvals
    • Conduct trainings and prepare training documentation for teams
    • Other duties as assigned

Strategic Business Analysis
Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps.
Applies understanding of health care regulations, managed care claims workflows, and provider reimbursement models to shape payment integrity related recommendations and action plans.
Translates strategic needs into clear requirements, workflows, and solutions that drive measurable improvement.
Partners with finance and compliance to develop business cases and support reporting that ties operational outcomes to financial targets.

Applied Analytical Support
Uses data analysis tools/systems to support business analysis.
Validates findings and tests assumptions through data, and leads with contextual knowledge of claims processing, provider contracts, and operational realities.
Creates succinct summaries and visualizations that enable faster leadership decision-making.
 

Required Qualifications

At least 4 years of business analyst experience in a managed care organization (MCO), and at least 2 years of experience in Medicaid and/or Medicare programs, or equivalent combination of relevant education and experience.
Proven experience owning operational projects from concept to execution, especially in the areas of provider reimbursement and claims payment integrity.
Strong working knowledge of managed care claims coding (Current Procedural Terminology (CPT), International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules.
Strong data analysis/queries experience, and ability to analyze data to inform business decisions.  
Strong business judgment, cross-functional coordination, and ownership of high-value deliverables.
Demonstrated ability to work independently and apply business judgment in a highly regulated, cross-functional environment.
Strong written and verbal communication skills, including ability to synthesize complex information.
Microsoft Office suite (including advanced Excel), and applicable software program(s) proficiency. 

  • Claims processing background
  • Experience with Medicare, Medicaid, and/or Marketplace lines of business.
  • Payment integrity (PI) programs
     

Preferred Qualifications

Experience with Medicare, Medicaid, and/or Marketplace lines of business.
Certified Business Analysis Professional (CBAP) or Certified Coding Specialist (CCS) certification.
Project management experience.
Familiarity with Medicaid-specific scorable action items (SAIs), operational cost-management efforts, payment integrity (PI) programs, and regulatory/compliance adherence.
 

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $83,252 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

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