Claims Analyst
About The Position
Free Market Health is seeking a detail-oriented Claims Analyst to join our team onsite at our Pittsburgh Headquarters. This role will help ensure the accuracy, integrity, and timely processing of our claims. In this role, you will monitor clearinghouse activity, validate claims, identify discrepancies, and help resolve issues that impact payment accuracy and the overall claims experience. This is a strong opportunity for someone who enjoys working with healthcare claims data, partnering across teams, and using problem-solving skills to support accurate, efficient claims operations.
Requirements
- 2+ years of experience with healthcare claims and related transactions.
- Knowledge of pharmacy billing, coding, or claims processing.
- Experience working with X12 and NCPDP transaction formats.
- Strong attention to detail and ability to monitor significant claim volume while managing multiple priorities.
- Clear communication skills and the ability to work collaboratively with cross-functional teams.
- Sound problem-solving skills, including the ability to identify issues, determine root causes, and follow through on resolution.
- Ability to handle sensitive healthcare information with professionalism and discretion.
Nice To Haves
- SQL knowledge or experience using data to research and resolve claims-related issues.
- College degree preferred, but not required.
Responsibilities
- Review and reconcile claims submitted through the claims clearinghouse to confirm successful receipt by payers.
- Review claims for payment accuracy based on applicable processing rules.
- Identify denied, rejected, or inaccurately paid claims and support timely follow-up and resolution.
- Partner with Pharmacy Operations, Client Services, and other internal teams to answer claim-related questions and communicate when action is needed.
- Monitor daily claims activity and proactively identify issues, trends, or process gaps that may impact accuracy or operational performance.
- Support accurate claims outcomes, revenue integrity, and a high-quality experience for clients and patients.
- Maintain confidentiality and protect sensitive healthcare information in accordance with HIPAA and company expectations.
- Take on additional responsibilities as needed to support the team and business priorities.
Benefits
- Generous PTO
- 100% employer-paid individual medical, dental, and vision premiums
- Employer HSA contribution
- Paid parental leave
- 401(k) match
- Transportation and parking benefits
- Flexible, collaborative work environment
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
