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Claims Examiner Analyst

Claims Examiner Analyst 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
47250 - 67750
Low
47250
The candidate is new to the role or has limited experience and is building necessary skills.
Mid
57750
The candidate has moderate experience in the role, meets most requirements or has equivalent transferable skills, and may also have relevant certifications.
High
67750
The candidate has extensive experience and advanced skills for the role, and may also have specialized certifications.
Projected salaries for related positions Job title Low Mid High Revenue Cycle Director 86000 111250 132250 Revenue Cycle Analyst 51250 65750 75250 Medical Billing/Collections Manager 86500 96250 106000 Medical Billing/Collections Supervisor 61500 75250 87500 Denials Specialist 37500 43000 50500 Medical Collections Specialist 39500 43000 51250 Medical Biller 39500 42750 50000 Payment Poster 37500 42000 46750 Charge Entry Clerk 37000 40750 46250 Claims Processor – Healthcare 36750 40750 47250

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Our starting salary projections come from a rigorous, multistep process so that our numbers accurately reflect the marketplace. They are based on actual compensation for professionals Robert Half has matched with employers across the country and third-party job posting data from Textkernel that we use to independently validate the salary levels. Starting compensation—pay for someone new to a role—can vary significantly based on a candidate’s skills, experience and certifications, as well as other factors including industry, company size and revenue, and demand for the role. To reflect this variability, we report our salary data in three levels: low, mid and high.