Claims Analyst

Insight Global; Red Bank (NJ); Hybrid; USD 23,000 - 40,000; Full time

Job summary

Insight Global’s client is seeking a detail-oriented Claims Analyst to support a growing plastic and reconstructive surgery practice in Red Bank, NJ. This role is part of a high-volume medical billing and revenue cycle team, handling insurance claim resolution, denials, AR follow-up, and collections for both in-network and out-of-network claims.

The ideal candidate has 2+ years of medical billing and collections experience, strong EOB interpretation skills, and familiarity with CPT/ ICD codes

Qualifications

• 2+ years of medical billing, medical collections, AR follow-up, or denials experience.
• Strong ability to read and interpret EOBs; comfortable walking through both in-network and out-of-network EOB examples.
• Working knowledge of insurance claim processing, payer follow-up, claim denials, adjustments, refunds, and outstanding AR.
• Experience working with in-network and out-of-network medical claims.
• Familiarity with CPT codes, ICD codes, medical terminology, and common billing forms such as CMS-1500/HCFA and UB-04.
• Ability to work a high-volume claims queue while balancing speed, accuracy, and quality of documentation.
• Strong communication skills for payer follow-up, internal collaboration, and documentation.
• Adaptable, team-oriented mindset with the ability to follow established processes and build on existing training.

Responsibilities

• Resolve outstanding insurance claims and follow up on denials.
• Review EOBs and follow up with payers to resolve discrepancies.
• Triage and work aged AR for in-network and out-of-network claims.
• Document actions and maintain clear audit trails.

Skills

Medical billing

AR follow-up

EOB interpretation

In-network / OON claims

Tools

TriZetto

EDI workflows

Clearinghouse systems

CMS-1500/HCFA

UB-04

Job description

Insight Global’s client is seeking a detail-oriented Claims Analyst to support a growing plastic and reconstructive surgery practice in Red Bank, NJ. This individual will join a high-volume medical billing and revenue cycle team, focusing on insurance claim resolution, denials, AR follow-up, and collections across both in-network and out-of-network claims. This person will be responsible for working outstanding insurance claims, troubleshooting denials, reviewing EOBs, following up with payers, and helping resolve aged receivables across both in-network and out-of-network claims. The ideal candidate has strong medical collections experience, understands how to read and interpret EOBs, and can confidently work claims from

Required Skills & Experience:

• 2+ years of medical billing, medical collections, AR follow-up, or denials experience.
• Strong ability to read and interpret EOBs; candidates should be comfortable walking through both in-network and out-of-network EOB examples.
• Working knowledge of insurance claim processing, payer follow-up, claim denials, adjustments, refunds, and outstanding AR.
• Experience working with in-network and out-of-network medical claims.
• Familiarity with CPT codes, ICD codes, medical terminology, and common billing forms such as CMS-1500/HCFA and UB-04. -Ability to work a high-volume claims queue while balancing speed, accuracy, and quality of documentation.
• Strong communication skills for payer follow-up, internal collaboration, and documentation.
• Adaptable, team-oriented mindset with the ability to follow established processes and build on existing training.

Nice to Have Skills & Experience:

• Experience supporting surgical, specialty, or high-volume healthcare billing environments.
• Experience with payer portals and EDI claim rejection workflows.
• Familiarity with TriZetto or similar clearinghouse systems.
• Experience working claims for major commercial payers such as Horizon, Aetna, Cigna, or similar carriers.
• Out-of-network claims experience, especially with longer aging cycles or No Surprises Act-related follow-up

This role is paying up to $29/hr for the right candidate and can scale back to hybrid (3 days a week on site) after the first 90 days!