Payment Insight Analyst I

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Payment Insight Analyst I based in United States.

As a Payment Insight Analyst I, you will play an important role in ensuring healthcare claims are reviewed and repriced accurately and consistently.
You will analyze claim information, contractual terms, client requirements, and system data to determine appropriate payment methodologies.
The role combines healthcare claims knowledge, analytical thinking, attention to detail, and a strong commitment to compliance.
You will collaborate with internal audit and operational teams to support quality, accuracy, and continuous improvement initiatives.
Success in this position requires meeting established productivity and quality metrics while following defined workflows and procedures.
You will work in a structured, remote environment where confidentiality, reliability, and clear communication are essential.
This is an opportunity to develop expertise in healthcare payment processes while contributing to accurate and compliant claims outcomes.

• Review internal and client systems, claim documentation, and relevant information to determine eligibility and appropriate payment methodologies for healthcare claims.
• Analyze contractual terms, guidelines, and client-specific requirements to identify accurate claim repricing approaches.
• Apply established payment rules and client requirements consistently while maintaining high standards of accuracy and timeliness.
• Partner with internal audit and other operational teams to support compliance, quality assurance, and process improvement initiatives.
• Meet or exceed established performance expectations related to accuracy, productivity, timeliness, and overall claim-processing quality.
• Follow documented workflows, Standard Operating Procedures (SOPs), and applicable policies to ensure consistent claim processing.
• Maintain complete and organized documentation of claim reviews, repricing activities, outcomes, and supporting information.
• Identify discrepancies, unusual claim activity, or potential issues and escalate them according to established protocols.
• Communicate effectively with colleagues and cross-functional teams to resolve claim-related questions and support efficient processing.
• Participate in training and development activities to remain current on policies, procedures, client requirements, and process changes.
• Support initiatives designed to improve claim repricing accuracy, operational efficiency, and overall quality.
• Protect confidential client and patient information and comply with applicable HIPAA and data-protection requirements.
• Assist with operational reporting, data compilation, special projects, and other responsibilities assigned by management.

Requirements

• High school diploma or GED required, with an Associate’s or Bachelor’s degree in Business, Healthcare Administration, Finance, or a related field preferred.
• At least one year of professional experience, with experience in healthcare, insurance, claims processing, or a related environment preferred; relevant education or training may be considered in place of some professional experience.
• Familiarity with healthcare claims, insurance processes, data analysis, documentation, or administrative operations is advantageous.
• Strong analytical and problem-solving abilities, with exceptional attention to detail and accuracy when reviewing data and claim information.
• Ability to interpret contracts, guidelines, client requirements, workflows, and established procedures and apply them consistently.
• Experience working within quality standards, compliance processes, or regulated environments is a plus.
• Proficiency with computer systems and common office applications such as Microsoft Excel, Word, and Outlook.
• Strong written and verbal communication skills, with the ability to exchange information clearly and professionally.
• Excellent organizational and time-management skills, with the ability to manage multiple priorities, maintain focus, and meet deadlines and performance targets.
• Ability to work independently while also collaborating effectively with team members and internal stakeholders.
• Willingness to learn new processes, systems, policies, and healthcare payment requirements.
• Demonstrated professionalism, reliability, sound judgment, and commitment to maintaining confidentiality.
• Ability to work remotely with reliable high-speed internet access and a dedicated, secure workspace.
• Ability to remain stationary for extended periods and perform repetitive motions involving the hands, wrists, or fingers.

Benefits

• Base compensation of $19.00–$22.75 per hour, with individual offers determined by experience, education, skills, certifications, and other relevant factors.
• Eligibility for overtime pay for nonexempt employees working beyond 40 hours per week, where applicable under state law.
• Medical, dental, and vision insurance coverage.
• Disability and life insurance benefits.
• 401(k) savings plan.
• Paid family leave.
• 9 paid holidays per year.
• 17–27 days of Paid Time Off (PTO) annually, depending on level and length of service.
• Fully remote work opportunity within the United States.
• Opportunities to develop expertise in healthcare claims, payment integrity, compliance, and analytical processes.
• A collaborative environment focused on professional development, accuracy, and continuous improvement.

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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