This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Claims Analyst based in the United States.
This role plays a key part in improving efficiency and accuracy within healthcare payment systems by identifying, analyzing, and supporting the recovery of claim overpayments. You will work at the intersection of data analysis, healthcare policy, and client collaboration, helping ensure claims are processed correctly and fairly. The position involves deep investigative work across claims systems, contracts, and reimbursement policies to uncover patterns and opportunities for financial recovery. You will collaborate closely with internal teams, clients, and external stakeholders to validate findings and resolve disputes. This is a highly analytical role where attention to detail, problem-solving, and structured thinking are essential. You will contribute directly to reducing waste in healthcare while supporting better alignment between payers and providers.
Accountabilities:
- Analyze healthcare claims data to identify, validate, and support recovery of potential overpayments.
- Review client claims adjudication systems, contracts, and payment policies to ensure accurate interpretation and application.
- Investigate and resolve disputed claims in collaboration with clients and providers.
- Research industry guidelines (including CMS and Medicaid policies) to uncover new overpayment opportunities.
- Develop, test, document, and refine new claims analysis concepts and overpayment detection scenarios.
- Collaborate with internal teams and management to improve algorithms, workflows, and identification processes.
- Provide insights and feedback on claim trends, productivity, and process improvements.
Requirements:
- Bachelor’s degree in Accounting, Business, Healthcare, or a related field, or equivalent relevant experience.
- Strong analytical and problem-solving skills with a high level of attention to detail.
- Experience working with or analyzing healthcare claims or payment integrity processes is preferred.
- Proficiency in Microsoft Excel and strong general computer literacy.
- Excellent written and verbal communication skills with the ability to work across multiple stakeholders.
- Strong organizational and time management abilities in a deadline-driven environment.
- Ability to learn and apply new systems, tools, and healthcare policy concepts quickly.
- Self-motivated, proactive mindset with the ability to work independently and collaboratively.
Benefits:
- Competitive salary range of $50,000 – $60,000 per year.
- Eligibility for performance-based incentive programs.
- Health insurance coverage and comprehensive benefits package.
- 401(k) plan with employer matching contributions.
- Paid parental leave and additional paid time off.
- Opportunity to contribute to meaningful healthcare cost optimization initiatives.
- Exposure to advanced payment integrity tools and healthcare data systems.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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