Medical Claims Analyst

Required Qualifications

• 2+ years of medical billing, medical collections, AR follow-up, or denials experience
• Strong ability to read and interpret EOBs, including in-network and out-of-network examples
• Working knowledge of insurance claim processing, payer follow-up, claim denials, adjustments, refunds, and outstanding AR
• Experience working with in-network and out-of-network medical claims
• Familiarity with CPT codes, ICD codes, medical terminology, and billing forms such as CMS-1500/HCFA and UB-04
• Ability to work a high-volume claims queue while maintaining speed, accuracy, and documentation quality
• Strong communication skills for payer follow-up, internal collaboration, and documentation
• Adaptable, team-oriented mindset with the ability to follow established processes

Preferred Qualifications

• Experience supporting surgical, specialty, or high-volume healthcare billing environments
• Experience with payer portals and EDI claim rejection workflows
• Familiarity with TriZetto or similar clearinghouse systems
• Experience working claims for major commercial payers such as Horizon, Aetna, or Cigna
• Out-of-network claims experience, including longer aging cycles or No Surprises Act-related follow-up

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Life insurance
• HSA
• Long-term disability insurance
• 401(k)
• Profit sharing
• Paid time off
• Contribution to health benefits
• Company discounts on products and services