Claims Analyst

We are recruiting a Claims Analyst for a temp-to-hire opportunity with a growing organization in the insurance and healthcare administration space. This role is responsible for reviewing, analyzing, and adjudicating medical claims with accuracy, efficiency, and strong attention to plan guidelines.

This is a great opportunity for a detail-oriented professional who enjoys research, problem-solving, and working with healthcare claims data. The team offers a supportive environment where motivated candidates can continue developing their claims administration knowledge, collaborate with multiple departments, and contribute to a service-focused operation.

Local candidates in Baton Rouge, LA are preferred, but qualified remote applicants will also be considered.

Key Responsibilities

- Review and process medical claims accurately and timely according to plan documents, eligibility requirements, and established guidelines.
- Analyze claims for benefits, coding, pricing, reimbursement accuracy, and required supporting documentation.
- Research claim issues, identify discrepancies, and coordinate with internal departments to resolve questions or concerns.
- Maintain accurate claim documentation and ensure all activity is completed in compliance with HIPAA and company policies.
- Meet established quality, productivity, and turnaround standards while supporting members, providers, employers, and internal teams.
- Assist with special projects and other claims administration duties as assigned.

Compensation and Benefits

- Pay: $19.00 to $22.00 per hour.
- Job Type: Temp-to-Hire.
- Location: Baton Rouge, LA.
- Work Arrangement: Local candidates are preferred, but qualified remote applicants will also be considered.

Equal Opportunity Employer / Disabled / Protected Veterans

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For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

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We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

Additional Skills

Required Qualifications and Skills

- Review, analyze, and adjudicate medical claims according to plan documents and claims processing guidelines.
- Research claim discrepancies and determine appropriate eligibility, benefits, coding, and reimbursement outcomes.
- Coordinate with Customer Service, Eligibility, Account Management, and other internal departments to resolve claim issues.
- Maintain accurate records and meet quality, productivity, and compliance standards.

- High School Diploma or GED required.
- Medical claims processing or health insurance experience preferred, with willingness to train motivated candidates who have strong analytical skills.
- Strong attention to detail and ability to interpret benefit plans, claim documentation, and reimbursement information.
- Proficiency with Microsoft Office, particularly Outlook and Excel.

- Excellent organizational, time management, written communication, and verbal communication skills.
- Ability to work independently, prioritize workload, learn new systems quickly, and maintain a positive, professional attitude.
- Understanding of HIPAA compliance and confidentiality expectations in a healthcare or insurance environment.

Preferred Qualifications

- 1 to 3 years of medical claims processing or health insurance experience.
- Experience with a Third-Party Administrator, insurance carrier, or healthcare organization.
- Experience with LuminX claims software.
- Understanding of medical terminology.
- Knowledge of CPT, HCPCS, and ICD coding.
- Familiarity with Explanation of Benefits.
- Basic understanding of Coordination of Benefits.
- Experience with medical claims adjudication, self-funded health plans, PPO networks, deductibles, copays, coinsurance, and out-of-pocket maximums.
- Additional education beyond High School Diploma or GED.

Please send your resume to View email address on appleone.com  Thank you!!