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Senior Claims Recovery Analyst Jobs (NOW HIRING)

AmericanAg®

Senior Claims Manager

Schaumburg, IL · On-site

$165K - $190K/yr

As a Senior Claims Manager, you will be a trusted advisor to internal and external clients. You ... Experience drafting clear, concise legal analyses, coverage evaluations, position statements, and ...

JLab Audio

Revenue Recovery Analyst

Carlsbad, CA · On-site

$60K - $85K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... and claims. This role drives measurable financial impact through dispute recovery, financial ... Success in this role requires sharp analytical thinking, attention to detail, fluency in financial ...

AmericanAg®

Senior Claims Manager

Schaumburg, IL · On-site

$165K - $190K/yr

As a Senior Claims Manager, you will be a trusted advisor to internal and external clients. You ... Experience drafting clear, concise legal analyses, coverage evaluations, position statements, and ...

Main Street Renewal

Senior Claims Consultant

Austin, TX · On-site +1

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Analyze claim documentation and supporting evidence to ensureappropriate claimoutcomes. * Provide ... Support disaster response activities and claim recovery initiatives. TPA, Carrier & Vendor ...

Network Health, Inc

COB & Recovery Analyst

Menasha, WI · On-site +1

Network Health is seeking a COB and Recovery Analyst who will use their advanced knowledge of ... Assumes responsibility for accuracy, timeliness and efficiency of COB claims following established ...

Artius Solutions

Senior Claims Specialist

Orange, CA · On-site

$110K - $130K/yr

Senior Claims Specialist - Medical Malpractice Location: Orange, CA 92859 (Onsite) Employment Type ... The ideal candidate will bring strong analytical expertise, litigation management experience, and ...

JLab Audio

Revenue Recovery Analyst

Carlsbad, CA · On-site

$60K - $85K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... and claims. This role drives measurable financial impact through dispute recovery, financial ... Success in this role requires sharp analytical thinking, attention to detail, fluency in financial ...

CareAllies

Sr Claims Analyst - LHB

$18.07 - $33.92/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

In addition to these tasks, the Senior Claims Analyst is responsible for all of the same tasks as a Claim Analyst including the accurate adjudication and processing of medical, dental, vision, or ...

Dearborn Group

Sr Claims Analyst - LHB

Lombard, IL · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

In addition to these tasks, the Senior Claims Analyst is responsible for all of the same tasks as a Claim Analyst including the accurate adjudication and processing of medical, dental, vision, or ...

Network Health

COB & Recovery Analyst

Menasha, WI · On-site +1

Network Health is seeking a COB and Recovery Analyst who will use their advanced knowledge of ... Assumes responsibility for accuracy, timeliness and efficiency of COB claims following established ...

Luminare Health

Sr Claims Analyst - LHB

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

In addition to these tasks, the Senior Claims Analyst is responsible for all of the same tasks as a Claim Analyst including the accurate adjudication and processing of medical, dental, vision, or ...

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Senior Claims Recovery Analyst information

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

As of Aug 14, 2026, the average hourly pay for senior 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 is the difference between Senior Claims Recovery Analyst vs Claims Recovery Analyst?

AspectSenior Claims Recovery AnalystClaims Recovery Analyst
Required CredentialsBachelor's degree, relevant certifications (e.g., CPCU, ARM)Bachelor's degree often preferred, certifications optional
Work EnvironmentCorporate insurance or claims departments, often in larger organizationsInsurance companies, third-party claims firms, or legal offices
Employer & Industry UsageUsed in insurance and claims industries for complex recoveriesCommon in insurance claims recovery roles across various companies

The main difference is that a Senior Claims Recovery Analyst typically handles more complex cases, requires more experience and certifications, and may oversee junior staff. A Claims Recovery Analyst generally manages standard recovery tasks. Both roles are vital in insurance recovery processes but differ in scope and seniority.

What cities are hiring for Senior Claims Recovery Analyst jobs?

Cities with the most Senior 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:

What states have the most Senior Claims Recovery Analyst jobs?

States with the most job openings for Senior Claims Recovery Analyst jobs include:

Senior Claims Recovery Analyst jobs near you

Senior Claims Analyst - Hospital Bill Review

SmartLight Analytics

Plano, TX • On-site, Remote

$85K - $105K/yr

Full-time

Posted 29 days ago

Job description

We are seeking an experienced Senior Claims Analyst with deep expertise in hospital claims adjudication, stop loss reporting, high-cost/catastrophic claims, and DRG (Diagnosis-Related Group) reimbursement methodology. This individual will analyze itemized hospital bills and claims data to identify billing errors, coding discrepancies, DRG misassignments, and other overpayment opportunities, then work directly with claims administrators on behalf of our ASO clients to secure claim adjustments, recoveries, and repricing.
This is a highly analytical, client-facing role requiring both technical claims expertise and strong negotiation/communication skills.
Key Responsibilities
Claims Analysis & Review
  • Perform detailed audits of hospital and facility claims, including itemized bills, UB-04 claim forms, medical records, and remittance advices, to validate billing accuracy.
  • Analyze DRG assignments and coding to identify DRG upcoding, unbundling, duplicate billing, and other irregularities that affect reimbursement.
  • Review high-cost and catastrophic claims (typically $100K+) to identify overpayments, contract misapplication, and opportunities for negotiated adjustments.
  • Evaluate claims against plan documents, provider contracts, reference-based pricing methodologies, and CMS guidelines to determine appropriate reimbursement.
Stop Loss & High-Cost Claims Expertise
  • Understand and apply stop loss (specific and aggregate) provisions, laser terms, and reporting requirements as they relate to claim adjustments and client financial exposure.
  • Coordinate with stop loss carriers and reinsurers as needed to ensure adjustments and recoveries are properly reflected in stop loss reimbursement calculations.
  • Identify claims nearing or exceeding specific deductible thresholds and prioritize review accordingly.
Client Advocacy & Claims Administrator Negotiation
  • Serve as the subject matter expert and advocate on behalf of ASO clients in disputes with claims administrators (TPAs) and carriers regarding claim payment accuracy.
  • Prepare clear, well-documented findings packages (clinical, contractual, and coding rationale) to support requested claim adjustments and appeals.
  • Lead or support negotiations with claims administrators to reach adjusted payment resolutions.
  • Track disputes through resolution, escalating unresolved cases appropriately and maintaining strong working relationships with TPA claims and provider relations teams.
Data & Reporting
  • Analyze large claims data sets to identify trends, outlier claims, and systemic overpayment patterns across client populations.
  • Build and maintain claim tracking logs, savings reports, and client-facing summaries of identified and recovered savings.
  • Partner with internal data/analytics teams to refine claim-flagging logic and improve identification of high-value review opportunities.
Required Qualifications
  • 5+ years of experience in hospital claims analysis, medical bill review, claims auditing, or payment integrity, with direct exposure to self-funded/ASO plans.
  • Strong working knowledge of DRG methodology (MS-DRG/APR-DRG), UB-04 billing, ICD-10-CM/PCS, CPT/HCPCS coding, and hospital chargemaster structures.
  • Demonstrated understanding of stop loss insurance, including specific/aggregate deductibles, laser provisions, and how claim adjustments impact stop loss reimbursement.
  • Experience analyzing high-cost/catastrophic claims and identifying overpayment or billing error patterns.
  • Prior experience interacting with or negotiating against TPAs, insurance carriers, or claims administrators on disputed claims.
  • Proficiency with claims data analysis tools (Excel required; SQL, Access, or claims analytics platforms a plus)
  • Excellent written and verbal communication skills, with the ability to build persuasive, well-supported adjustment requests and appeals.
  • Strong attention to detail and ability to manage a high volume of complex claims simultaneously.
Preferred Qualifications
  • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Medical Bill Review Specialist, or similar credential.
  • Prior experience at a TPA, insurance carrier, hospital billing/coding department, or payment integrity/cost containment vendor.
  • Familiarity with reference-based pricing (RBP), Medicare fee schedules, and out-of-network claims repricing.
  • Nursing background (RN) or clinical coding background is a plus for clinical validation of DRG and medical necessity issues.
What Success Looks Like
  • Consistent identification of material overpayments and billing errors on high-cost hospital claims.
  • Strong track record of securing favorable claim adjustments through negotiation with claims administrators.
  • Clear, professional communication that strengthens client trust and TPA relationships.
  • Measurable contribution to client savings and stop loss cost containment.

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