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Claims Examiner Analyst in Houston, TX

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 in Houston, TX
52448 - 75203
Low
52448
The candidate is new to the role or has limited experience and is building necessary skills.
Mid
64103
The candidate has moderate experience in the role, meets most requirements or has equivalent transferable skills, and may also have relevant certifications.
High
75203
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 95460 123488 146798 Revenue Cycle Analyst 56888 72983 83528 Medical Billing/Collections Manager 96015 106838 117660 Medical Billing/Collections Supervisor 68265 83528 97125 Denials Specialist 41625 47730 56055 Medical Collections Specialist 43845 47730 56888 Medical Biller 43845 47453 55500 Payment Poster 41625 46620 51893 Charge Entry Clerk 41070 45233 51338 Claims Processor – Healthcare 40793 45233 52448

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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.