Medical Billing Claims Analyst

TriHealth • Norwood, OH

5h • Onsite

About The Position

The Medical Billing Claims Analyst is primarily responsible for ensuring claims are submitted to the clearinghouse accurately, cleanly, and on time each day. The analyst monitors clean claim performance, runs daily audits, and shares reports on claim rates, volumes, trends, and opportunities with leadership. The role serves as a liaison between IT and the external clearinghouse vendor to maintain payer edits and implement enhancements that reduce claim rejections and denials. The analyst also assists billing teams with processing issues and educates team members on using clearinghouse data to expedite claims and support standardized billing practices.

The position is based at TriHealth’s Norwood location and is full-time, 80 hours biweekly, on the day shift. There is no weekend, holiday, or on-call commitment. The analyst works collaboratively with billing departments, IT, and the clearinghouse vendor, and is expected to demonstrate TriHealth’s SERVE standards and ALWAYS behaviors.

Requirements

• High school diploma or GED.
• Four to five years of experience in a related field.
• Meets all requirements for Medical Biller III.
• Strong verbal and written communication skills, including the ability to communicate software and technical issues to billing teams and the clearinghouse vendor.

Responsibilities

• Ensure claims are submitted to the clearinghouse accurately, cleanly, and on time each day.
• Run daily audits to monitor the clean claim rate and identify opportunities to enhance edits in Epic.
• Share daily reports with leadership, including claim volumes, trends, and clean claim performance.
• Act as a liaison between IT and the external clearinghouse vendor to maintain edits and implement enhancements that reduce rejections and denials.
• Help billing teams resolve claims and processing issues.
• Educate billing team members on using clearinghouse data to expedite claim processing.
• Maintain ongoing vendor changes to support innovation and keep Epic robust.
• Respond to questions from IT and the clearinghouse vendor to ensure agreement on workflows between Epic and the clearinghouse.
• Maintain close working relationships with billing departments to consolidate efforts and ensure standardized billing procedures are followed.
• Perform other duties as assigned by leadership.
• Communicate software and technical issues effectively with billing teams and the clearinghouse vendor.

Benefits

• Comprehensive benefits package, including medical, dental, and vision coverage, paid time off, retirement plans, and tuition reimbursement.
• Competitive shift differentials, with the opportunity to earn up to an additional $7 per hour based on shift, hours worked, and organizational guidelines.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED