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Claims Examiner Analyst Healthcare

Claims Examiner Analyst Healthcare Job Description

These professionals must have knowledge of standard claims coding and the ability to process all claim types, as well as experience with healthcare benefits structures and insurance procedures. Candidates should have strong writing and verbal skills and be proficient with Microsoft Office and familiar with HIPAA provisions. An associate’s degree or commensurate work experience is required.

Typical claims examiner analyst duties:

Reviewing and evaluating incoming claims for appropriate coding against the charges that are being billedDetermining the level of reimbursement based on established criteria, provider contract or plan provisionsDenying all claims ineligible for payment and entering coding informationIdentifying and reporting inaccuracies that are related to system configuration, benefit inconsistency and fee schedulesIdentifying circumstances that require claim payment, development or denial and producing the appropriate corresponding outcomes

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Salary for Claims Examiner Analyst Healthcare
47000 - 67500
25th percentile
47000
The candidate is new to the role and building the needed skills, experience and autonomy.
50th percentile
57750
The candidate has the experience to perform core responsibilities without direct supervision and is comfortable with the role’s processes and subject matter.
75th percentile
67500
The candidate delivers value beyond the stated job duties, has advanced qualifications and experience, and is ready for the next career level.
Projected salaries for related positions Position title 25th percentile 50th percentile 75th percentile Revenue Cycle Director – Healthcare 84500 109750 130250 Medical Collections Manager/Supervisor 61500 75250 87500 Medical Collections Specialist 36250 41000 48250 Medical Billing Manager/Supervisor 60000 74250 84000 Medical Biller 37500 41750 48500 Revenue Cycle Analyst – Healthcare 50000 64000 73000 Denials Specialist – Healthcare 37250 43000 50250 Payment Poster – Healthcare 36750 41750 46250 Charge Entry Clerk – Healthcare 36500 40500 45500 Claims Processor – Healthcare 36250 40500 46750

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