NOW HIRING: Medical Claims Analyst (Hybrid)
Location: Harrisburg, PA (Hybrid - 2 Days Onsite Weekly)
Pay: $23.00 per hour
Monday-Friday | No Weekends
Overview:
Are you an experienced healthcare revenue cycle professional with a background in medical billing, claims analysis, denial resolution, or provider support? We're seeking a detail-oriented Medical Claims Analyst to join a collaborative team supporting Pennsylvania's Medical Assistance (Medicaid) program.
This hybrid opportunity offers a stable weekday schedule with no weekend work while allowing you to work remotely three days per week.
Position Summary
In this role, you'll research and resolve Medical Assistance (Medicaid) billing inquiries, investigate denied claims, interpret remittance advice, and assist healthcare providers with billing questions. You'll serve as a subject matter resource by ensuring claims are processed accurately while delivering outstanding customer service to providers and Medical Assistance recipients.
Responsibilities
- Analyze Medical Assistance billing inquiries to determine claim accuracy and appropriate payment.
- Investigate denied and rejected claims, identify root causes, and explain denial reasons according to Pennsylvania Medical Assistance billing guidelines.
- Review Remittance Advice (RA), Explanation of Benefits (EOB), payment adjustments, recoupments, and take-backs.
- Respond to provider and recipient inquiries regarding billing, claim status, eligibility, benefits, and reimbursement.
- Evaluate claims for accurate procedure codes, modifiers, and prior authorization requirements.
- Determine eligibility for 180-day exception processing.
- Research recipient eligibility and covered Medical Assistance services.
- Assist recipients with reimbursement requests and educate providers on Medical Assistance billing policies and procedures.
- Review billing history to identify duplicate claims and prevent future denials.
- Conduct dental history research as needed.
- Maintain detailed documentation while providing exceptional customer service.
Experience with healthcare billing systems, EHRs, payer guidelines, insurance claims processing, and provider communication is highly preferred.
Schedule & Location
- Pay: $23.00/hour
- Schedule: Monday-Friday
- Location: Harrisburg, PA
- Hybrid: Work remotely three days per week and onsite two days per week.
If you're looking for an opportunity to utilize your medical billing, revenue cycle, or healthcare claims experience while enjoying a consistent weekday schedule and hybrid flexibility, we'd love to hear from you. Apply today!
Alliston Brown | 586-710-7944 | [email protected]
INDKS
Pay: $23.00 per hour
Benefits:
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: Hybrid remote in Harrisburg, PA 17111
