Claims Analyst

1 week ago – Be among the first 25 applicants.

This range is provided by RSi. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

$20.00/hr - $22.00/hr

Join our dynamic Medicaid Enrollment Department as a Claims Analyst. In this hybrid role, you’ll work both remotely and in-office (three days per week), supporting Medicaid enrollment and retro authorization processes. You’ll collaborate with internal teams and external partners to ensure timely and accurate authorization, with opportunities to expand into Enrollment Specialist duties as needed.

• Process retro authorization requests for Medicaid, ensuring compliance with state and federal guidelines.
• Collaborate with hospital personnel, clients, and payers to verify eligibility and secure authorizations.
• Respond promptly to daily inquiries and resolve issues related to Medicaid enrollment and authorizations.
• Maintain effective workflow and support organizational standards, policies, and procedures.
• Foster a positive, customer‑focused work culture.
• Support enrollment activities, including application review, eligibility verification, and documentation.
• Perform other duties as assigned, including Enrollment Specialist tasks when required.

• High School Diploma or equivalent.
• Authorized to work in the United States; able to pass a background check.
• Exceptional customer service and communication skills.
• Strong problem‑solving and case management abilities.
• Proficiency with technology (Microsoft Word, Excel, Outlook, phone systems, etc.).
• Ability to work independently and collaboratively in a hybrid environment.

• Experience with Medicaid, Medicare, TPL, and commercial insurance recovery.
• Understanding of HIPAA and HITECH patient confidentiality laws.
• Familiarity with hospital systems and healthcare environments.
• Prior experience in enrollment or authorization roles.

• Competitive salary.
• Medical, dental, and vision insurance.
• Company‑paid life insurance.
• Paid volunteer time off.
• Free wellness memberships.
• 401(k) retirement plan.
• Paid training and mentoring.
• Opportunities for advancement.

Work will be primarily performed remotely. Candidates must have a stable dedicated workspace and secure internet connectivity. Computer equipment will be provided by the Company. Requires prolonged sitting, standing, or walking. Requires on‑camera interactions with colleagues, leadership, and occasionally, clients. Appropriate work attire and professional setting are required. Requires eye‑hand coordination and manual dexterity to operate computer hardware and office equipment.

Requires normal hearing and eyesight to record, prepare, and communicate reports. Requires lifting boxes up to 15 pounds occasionally. Work may be stressful t be an effective communicator with strong problem‑resolution abilities.

Claims Analysts must abide by client‑required policies such as wearing masks, providing COVID‑19 vaccination status, and testing, if on‑site visits occur.

Entry level.

Full‑time.

Finance and Sales.

Hospitals and Health Care.

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