Medical Claims Analyst

Job Description

Job Description

We are looking for a detail-oriented Medical Claims Analyst to join a team in Baton Rouge, Louisiana. This contract opportunity with permanent potential is ideal for someone with experience reviewing medical claims, resolving billing issues, and supporting accurate reimbursement outcomes. The person in this role will work closely with claim documentation, denial research, and payment records to help ensure claims are processed efficiently and correctly.

Responsibilities:
• Review medical claims for accuracy, completeness, and compliance before submission or follow-up activity.
• Investigate denied and rejected claims to identify root causes and take appropriate corrective action.
• Analyze explanation of benefits documents to reconcile payments, adjustments, and outstanding balances.
• Coordinate with internal teams and external payers to resolve billing discrepancies and claim status issues.
• Prepare and submit corrected claims when additional information or revisions are needed for adjudication.
• Monitor Medicaid claim activity and follow payer-specific guidelines to support timely reimbursement.
• Maintain detailed records of claim research, follow-up efforts, and resolution outcomes within tracking systems.
• Identify recurring claim problems and recommend process improvements to reduce denials and payment delays.• Experience working with medical claims in a healthcare, billing, or revenue cycle environment.
• Knowledge of claim denials, rejected claims, and effective follow-up practices.
• Familiarity with medical billing processes, payer responses, and explanation of benefits review.
• Working understanding of Medicaid claims and related reimbursement requirements.
• Strong attention to detail with the ability to identify discrepancies in billing and claim documentation.
• Ability to manage multiple claims issues at once while meeting deadlines and accuracy standards.
• Clear written and verbal communication skills for interacting with payers and internal stakeholders.