Medical Claims Analyst
Location: Duluth, GA (Preferred) -Hybrid
Remote: Remote candidates will be considered
Department: Claims
Reports To: Claims Manager
Non-Exempt/Hourly Monday through Friday 8:30 to 5 EST 37.5 workweek
Position Summary
We are looking for a detail-oriented Claims Analyst to join our Third Party Administrator team supporting health benefit programs. In this role, you will review, analyze, and process medical claims accurately and efficiently while providing responsive service to members, providers, employers, and internal teams.
Candidates with 1–3 years of medical claims experience are preferred, but we are willing to train motivated applicants who have strong analytical skills, attention to detail, and a willingness to learn.
Local candidates are preferred; qualified remote candidates will also be considered.
Essential Responsibilities
· Review, analyze, and process medical claims accurately and timely according to plan documents and established guidelines.
· Evaluate eligibility, benefits, coding, pricing, documentation, and reimbursement accuracy.
· Research claim issues, resolve discrepancies, and coordinate with Customer Service, Eligibility, Account Management, and other departments as needed.
· Maintain accurate documentation of claim activity.
· Meet established quality and productivity standards.
· Ensure compliance with HIPAA and company policies.
· Assist with special projects and other duties as assigned.
Desired Skills
· Strong analytical and critical thinking skills.
· Excellent attention to detail and accuracy.
· Ability to interpret benefit plans and claim documentation.
· Strong organizational and time management skills.
· Ability to work independently, prioritize workload, and learn new systems quickly.
· Excellent written and verbal communication skills.
· Proficiency with Microsoft Office, particularly Outlook and Excel.
· Positive attitude and willingness to learn.
What We’re Looking For
We are looking for someone who enjoys solving problems, produces accurate work, and brings professionalism to every interaction. The ideal candidate is dependable, organized, eager to learn, and able to work effectively both independently and as part of a team.
Why Join Our Team?
- Competitive compensation based on experience.
- Comprehensive benefits package, including medical, dental, vision, paid time off, retirement benefits, and other company-sponsored benefits.
- Stable, growing organization with an excellent reputation in the employee benefits industry.
- Collaborative, team-oriented culture where employees support one another.
- Opportunities for ongoing training, professional development, and career growth.
- Meaningful work where you’ll build lasting relationships and make a direct impact on our clients’ experience.
Pay: $19.00 - $22.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: Hybrid remote in Duluth, GA 30097
