Healthcare Claims Analyst

Job Summary

A company is looking for a Claims Analyst (Healthcare) to support their team in a remote capacity.

Key Responsibilities

• Research, resolve, and follow up on rejected or unpaid pharmacy claims for accurate reimbursement
• Serve as a subject matter expert on reimbursement, provider relationships, and claims processes
• Prepare reports, analyze trends, and communicate findings effectively to stakeholders

Required Qualifications

• Bachelor's degree in Business, Healthcare, or related field; equivalent experience considered
• 1-3 years of experience in healthcare billing, revenue cycle, coding, or pharmacy claims
• Strong knowledge of Medicare, third-party billing codes, CPT/HCPCS, ICD-10, and NCCI/MUE edits
• Certified Pharmacy Technician or coding certifications (CPC, RHIT) preferred
• Advanced analytical and interpersonal skills with the ability to work cross-functionally