Medical Bill Review Analyst

Job Description

Job Description

Our client is seeking a detail-oriented Medical Claims Pricing Analyst to help ensure healthcare claims are processed accurately and in accordance with established pricing agreements, fee schedules, and contractual requirements. This role is ideal for someone who enjoys analytical work, problem-solving, and working with complex healthcare billing information to ensure fair and accurate claim payments.

In this position, you will review medical claims, apply appropriate pricing methodologies, investigate billing discrepancies, and support the overall integrity of the claims process. The successful candidate will have a strong understanding of medical billing and coding, excellent attention to detail, and the ability to navigate complex reimbursement guidelines.

This position will be 20 hours a week.

Key Responsibilities

• Review medical claims to ensure pricing accuracy, procedural correctness, and compliance with contractual agreements.
• Apply state fee schedules, usual and customary pricing standards, and other reimbursement methodologies.
• Identify and resolve pricing discrepancies, billing errors, and claim adjustment issues.
• Conduct research on complex claims, reimbursement policies, and claim routing requirements.
• Analyze medical codes and billing information to support accurate claim adjudication.
• Help prevent overpayments and ensure consistency with established pricing rules and guidelines.
• Maintain accurate records and documentation related to claim reviews and adjustments.

Qualifications

• High school diploma or GED required; related coursework or certifications in medical billing, coding, or healthcare administration are a plus.
• One (1) to three (3) years of experience in medical claims processing, health insurance, medical billing, or revenue cycle operations.
• Strong knowledge of CPT, ICD-10, and healthcare billing terminology.
• Familiarity with provider contracts, fee schedules, and reimbursement methodologies.
• Proficiency with claims processing systems, databases, and Microsoft Excel.
• Excellent analytical, organizational, and problem-solving skills.
• Ability to work independently while maintaining a high level of accuracy and attention to detail.

If you're looking for an opportunity to apply your healthcare billing expertise in a meaningful and analytical role, this position offers the chance to make a direct impact on the accuracy and integrity of the claims process.

Marathon Staffing is an Equal Opportunity Employer and participates in E-Verify.

INDC

\nCompany Description

Our company enjoys longstanding stability, having been in business for over 30 years. We are an Equal Opportunity Employer and we strive to connect individuals with career opportunities that meet their specific needs.

Company Description

Our company enjoys longstanding stability, having been in business for over 30 years. We are an Equal Opportunity Employer and we strive to connect individuals with career opportunities that meet their specific needs.