ZipRecruiter

Log In

1

Revenue Cycle Claims Analyst Jobs (NOW HIRING)

next page

Showing results 1-20

All JobsRevenue Cycle Claims Analyst Jobs

Revenue Cycle Claims Analyst information

See salary details

$15

$25

$44

How much do revenue cycle claims analyst jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for revenue cycle claims analyst in the United States is $25.60, according to ZipRecruiter salary data. Most workers in this role earn between $19.71 and $27.16 per hour, depending on experience, location, and employer.

What is the difference between Revenue Cycle Claims Analyst vs Medical Billing Specialist?

AspectRevenue Cycle Claims AnalystMedical Billing Specialist
CredentialsCertification in medical billing or coding, knowledge of insurance policiesCertification often preferred, similar credentials
Work EnvironmentHealthcare facilities, insurance companies, revenue cycle departmentsMedical offices, billing companies, healthcare providers
Job FocusAnalyzing claims, resolving denials, optimizing revenue cycleSubmitting claims, coding, payment posting

The Revenue Cycle Claims Analyst and Medical Billing Specialist roles both involve billing and coding, but the analyst focuses more on analyzing claims data and resolving issues to improve revenue, while the specialist handles the day-to-day submission and processing of claims. Both roles require similar credentials and work in healthcare settings, but their primary responsibilities differ in scope and focus.

What are some common challenges a revenue cycle claims analyst faces when working with denied claims, and how can these be addressed?

A Revenue Cycle Claims Analyst often encounters challenges such as deciphering complex denial codes, managing high claim volumes, and communicating effectively with payers to resolve issues. Addressing these challenges requires strong attention to detail, persistence in following up on outstanding claims, and staying updated on payer policies and regulations. Collaborating closely with billing teams and leveraging analytical tools can help streamline the appeals process and reduce future denials.

What is a revenue cycle claims analyst?

A Revenue Cycle Claims Analyst is a professional who reviews, analyzes, and manages healthcare claims to ensure accurate billing and timely reimbursement from insurance companies. They identify and correct errors in claims submissions, work to resolve denials, and help optimize the revenue cycle process for healthcare providers. Their work is vital for maintaining the financial health of healthcare organizations by ensuring that all services rendered are properly billed and paid. Additionally, they may collaborate with billing teams, coders, and insurance representatives to address discrepancies and improve claim approval rates.

What are the key skills and qualifications needed to thrive as a revenue cycle claims analyst, and why are they important?

To thrive as a Revenue Cycle Claims Analyst, you need strong analytical skills, attention to detail, and a solid understanding of healthcare billing and insurance processes, often supported by a degree in healthcare administration or a related field. Familiarity with claims management software, electronic health record (EHR) systems, and knowledge of coding standards like ICD-10 and CPT are typically required. Excellent problem-solving skills, effective communication, and the ability to manage multiple tasks efficiently are standout soft skills for this role. These competencies are crucial for accurately processing claims, reducing denials, and ensuring timely reimbursement for healthcare organizations.
More about Revenue Cycle Claims Analyst jobs
What cities are hiring for Revenue Cycle Claims Analyst jobs? Cities with the most Revenue Cycle Claims Analyst job openings:
What states have the most Revenue Cycle Claims Analyst jobs? States with the most job openings for Revenue Cycle Claims Analyst jobs include:
What job categories do people searching Revenue Cycle Claims Analyst jobs look for? The top searched job categories for Revenue Cycle Claims Analyst jobs are:
Revenue Cycle Claims Analyst jobs near you
Infographic showing various Revenue Cycle Claims Analyst job openings in the United States as of August 2026, with employment types broken down into 93% Full Time, 5% Part Time, and 2% Contract. Highlights an 88% Physical, 2% Hybrid, and 10% Remote job distribution, with an average salary of $53,239 per year, or $25.6 per hour.

Claims Analyst Pharmacy Revenue Cycle

Boston Medical Center

Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Boston Medical Center rating

6.9

Company rating: 6.9 out of 10

Based on 108 frontline employees who took The Breakroom Quiz

551st of 1,055 rated hospitals

Job description

POSITION SUMMARY:
Revenue cycle management (RCM) is the financial process that makes it possible for healthcare organization to fulfil their mission of providing quality care for patients and communities. Pharmacy revenue cycle is complex process and requires a collaborative and specialized approach. Improving performance requires fine-tuned workflows, training, dedicated resources, collaboration across multiple departments, and routine updates to core systems.
Under the direction of the Revenue Cycle Supervisor Pharmacy, the Revenue Cycle Claims Analyst is responsible through extensive telephone and written correspondence, will pursue insurance companies for payment or underpayment of services rendered. Will also substantiate accurate reimbursement through correct contract terms, billing practices and compliance with state and federal guidelines. Must have the ability to analyze, audit, problem solve and reconcile an account is critical to this position. Conducts duties in accordance with industry federal and state billing guidelines and contractual obligations and in compliance with department policies and procedures.
As part of the Pharmacy Complex Claims team, we are able to bring traditional revenue cycle functions into the department of pharmacy which can provides significant opportunities for our health system. Key factors are hiring individuals with financial, pharmacy and medical revenue cycle expertise as a reimbursement solutions that identify and recover overlooked revenue for BMC.
Position: Claims Analyst Pharmacy Revenue Cycle
Department: Pharmacy Revenue Cycle
Schedule: Full Time
ESSENTIAL RESPONSIBILITIES / DUTIES:
  • Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected drug claims.
  • Serve as subject matter expert for strategic provider relationships, service issues, reimbursement and claims.
  • Possess excellent medical and billing terminology skills; Ability to read, analyze and interpret prescription drug orders.
  • Monitor rejections on all electronic and paper claims to determine where enhancements or fixes are needed in system edits to gain efficiencies and to prevent ongoing rejections.
  • Knowledge of Medicare and third-party codes and billing procedures as well as patient billing techniques.
  • Effectively communicate issues and results via multiple media including in-person meetings, workgroups, verbal communication, email and presentations.
  • Knowledge of Medicare and other regulatory billing codes and practices in order to assess billing for accuracy prior to submission to appropriate agency or company for processing and payment. Should be well-versed in regulatory guidelines and industry standards for Medicare and/or specific payer benefit providers.
  • Collaborates with team and other revenue cycle departments to improve denials, avoidable write-offs,
  • Applies analytical skills to pre-established work processes that may require preparation of reports or documents for further review or analysis.
  • Research, analyze, and respond to inquiries regarding compliance, payor policies and guidelines, inappropriate coding, denials, and billable services
  • Follow-up on outstanding account balances at 45-days from the date of service in accordance to organizational protocol with an emphasis on maximizing client satisfaction and provider profitability
  • Utilize Hospital's Core Values as the basis for decision making and to facilitate hospital mission.
  • Must adhere to all of BMC's RESPECT behavioral standards.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).
JOB REQUIREMENTS
EDUCATION:
  • Bachelor's degree in Business, Healthcare or closely related field or equivalent work experience.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:
  • Certified Pharmacy Technician (Preferred)
  • Coding Certification CPC, RHIT (preferred)

EXPERIENCE:
  • 1 to 3 years of experience in healthcare, coding, finance, revenue cycle, patient accounting and/or physician billing, preferably in a Medical Center setting, Oncology or Home/Office Infusion settings.

KNOWLEDGE AND SKILLS:
  • Requires advanced working knowledge of professional billing flows including charge entry, editing system functionality, and revenue cycle tasks.
  • Ability to analyze and solve complex problems related to system processes and workflows.
  • Responsible to monitor and resolve Claims Work queues; Specifically, Front End, Referrals & Authorizations, and Clinical Workflow.
  • Strong knowledge of claim edits NCCI (National Correct Coding Initiative (NCCI) Edits) and MUE (Mutually unlikely edits).
  • Ability to converts pharmacy drug quantities into Medicare billing units according to Medicare Guidelines prior to submitting medical CMS1500 claim forms.
  • Ensures all billable services are processed EPIC in a timely manner.
  • Superior analytical skills to critically evaluate information gathered from multiple sources and synthesize into actionable information
  • Strong interpersonal skills to elicit cooperation from a wide variety of sources, including upper management, clients, and other departments.
  • Strong interpersonal skills with attention to detail and ability to organize, interpret, and present data.
  • Must be able to present information effectively in both written and oral forms, tailoring messages to the audience.
  • Understanding and knowledge of the business, products, programs, corporate organizational structure (including functional responsibilities), and basic research principles/methodologies
  • Must have a working knowledge of (CPT/HCPCS and ICD-10-CM-PCS diagnosis codes, understand current professional coder workflows, reviews principal, secondary diagnoses and procedures for hospital and physician (professional) services for inpatient, outpatient, and infusion records based on knowledge of coding systems). Knowledge of hospital and professional billing, collection and reimbursement requirements and standard practice.
  • Must have working knowledge of drug NDC numbers and unit conversion
  • SME (Subject Matter Expert) for complex denials and payment variances including contracts, fee schedules, and edits. Educates and provides feedback to various areas on Pharmacy Revenue Cycle rejection metrics and key performance indicators.

Compensation Range:
$56,000.00- $78,500.00
This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being.
NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location.
Equal Opportunity Employer/Disabled/Veterans
According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or "apps" job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

What Boston Medical Center employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Boston Medical Center logo

About Boston Medical Center

Sourced by ZipRecruiter

Boston Medical Center (BMC) is more than a hospital. It's a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New England. Emphasizing community-based care, BMC is committed to providing consistently excellent and accessible health services to all-and is the largest safety-net hospital in New England. The hospital is also the primary teaching affiliate of the nationally ranked Boston University School of Medicine (BUSM) and a founding partner of Boston HealthNet - an integrated health care delivery systems that includes many community health centers. Join BMC today and help us achieve our Vision 2030 which is a long-term goal to make Boston the healthiest urban population in the world.

Industry

Hospitals

Company size

1,001 - 5,000 Employees

Headquarters location

Boston, MA, US

Year founded

1996

View All Boston Medical Center Jobs

Apply