Medical Claims Analyst (Auditor)

Job Description

Job Description

Medical Claims Analyst (Auditor)  

·         Houston Heights, TX, 90045

·         $25.00/hour

·         Monday-Friday | 8:00 AM - 5:00 PM

·         100% Onsite

·         Contract-to-Hire

Join a growing healthcare services organization specializing in medical claims review and reimbursement support. We are seeking a detail-oriented professional with experience in medical billing, coding, claims review, healthcare administration, or insurance reimbursement.

Responsibilities

• Review and analyze medical claims for accuracy, quality, and compliance.
• Audit claim determinations and supporting documentation.
• Research claim discrepancies and identify trends.
• Communicate with providers, arbitrators, and stakeholders to obtain necessary documentation.
• Process claim determinations and enter information into company systems.
• Maintain accurate records and ensure deadlines are met.
• Support quality assurance and continuous improvement initiatives.

Qualifications

• Experience in medical billing, coding, claims processing, claims review, or healthcare administration.
• Strong analytical and problem-solving skills.
• Excellent attention to detail and accuracy.
• Strong written and verbal communication skills.
• Proficiency with data entry and navigating multiple systems.
• Knowledge of dispute resolution, arbitration, or regulatory processes is a plus.
• Medical Coding certification and/or paralegal experience is preferred.

Note: Due to the fully onsite schedule and Houston traffic, candidates should reside within approximately 30 minutes of the Houston Heights area.