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Medical Claims Repricer I

USA Managed Care Organization
West Lake Hills, TX

Quick Apply

Job Details

Full-time
$20 - $30 an hour

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Opportunities for advancement

Qualifications

Computer operation
Medical claims
High school diploma or GED
Attention to detail
Computer skills

Full Job Description

Medical Claims Repricer I

USA Managed Care Organization (USA MCO) – Austin, TX
Full-Time | In-Office | Monday–Friday

About Us

USA Managed Care Organization (USA MCO) is a leader in providing nationwide healthcare access with a focus on helping control the rising cost of healthcare while respecting providers’ authority in patient treatment. Our Health and Wellness Network is the nation’s largest, self-developed, privately held Preferred Provider Organization, serving millions of covered lives.

We are currently seeking a Medical Claims Repricer I to join our growing Claims Repricing team. This is a paperless processing role with minimal phone activity and strong career growth potential.

We highly value candidates with medical claims repricing experience; however, we also welcome motivated, detail-oriented individuals who are eager to learn and grow into a successful Repricer through training and hands-on development.

Position Summary

The Medical Claims Repricer I is responsible for reviewing and repricing medical claims for procedural, contractual, and pricing accuracy while meeting production and quality standards. This role works closely with multiple departments, as claims repricing is a key function that supports organization-wide operations.

Key Responsibilities

Maintain strict compliance with HIPAA, confidentiality, and security standards
Reprice medical claims using HCFA and UB forms with focus on accuracy and contract compliance
Meet established production and quality performance metrics
Collaborate with internal departments to support cross-functional workflows and repricing operations
Participate in cross-training to broaden repricing and operational knowledge
Assist with occasional overtime based on claim volume and turnaround needs
Perform additional duties as assigned

Qualifications

Required:

High School Diploma or GED
Strong computer skills and ability to learn multiple systems
High attention to detail and accuracy
Professional communication and teamwork skills
Reliable, coachable, and growth-oriented mindset

Preferred (but not required):

2+ years of recent medical claims processing or repricing experience
Experience with ICD/CPT coding
PPO / Group plan experience in a multi-tenant environment
AS400 / iSeries experience

Candidates without direct repricing experience but with strong analytical ability and willingness to learn are encouraged to apply.

Work Environment & Schedule

Location: Austin, TX (This is a full-time, in-office role)
Schedule: Monday – Friday, 8:00 AM – 4:30 PM CT (37.5 hours/week, 1-hour lunch)
Business Casual dress code
Company laptop provided

Why Join USA MCO?

Stable and growing organization
Career development and advancement opportunities
Hands-on training and cross-department exposure
Team-oriented, professional environment

Job Type: Full-time

Pay: $20.00 - $30.00 per hour

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance

Application Question(s):

What are your pay expectations

Experience:

recent medical claims-processing : 2 years (Preferred)

Ability to Commute:

West Lake Hills, TX 78746 (Required)

Work Location: In person

Quick Apply

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