Claims Analyst

Insight Global; Red Bank (NJ); On-site; USD 33,000 - 37,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401k

Job summary

Insight Global’s client in Red Bank, NJ seeks a detail-oriented Claims Analyst to support a high-volume medical billing and revenue cycle team, focusing on insurance claim resolution, denials, AR follow-up, and collections for in-network and out-of-network claims.

You will work outstanding claims, review EOBs, troubleshoot denials, follow up with payers, and document activities clearly, collaborating with internal staff to resolve aged receivables and maintain compliance.

Qualifications

• 2+ years of medical billing, medical collections, AR follow-up, or denials experience.
• Strong ability to read and interpret EOBs; comfortable with in-network and out-of-network claims.
• Experience with insurance claim processing, payer follow-up, denials, adjustments, refunds, and AR.
• Experience with in-network and out-of-network medical claims.
• Familiarity with CPT/ ICD codes and CMS-1500/HCFA and UB-04 forms.
• Ability to manage high-volume claims queue with accuracy and speed.
• Strong communication for payer follow-up and internal collaboration.

Responsibilities

• Work a blend of AR follow-up, denials management, and medical collections based on daily claim volume, aging, and dollar amount.
• Review, interpret, and troubleshoot EOBs to identify issues, underpayments, denials, missing documentation, coding concerns, and payer requirements.
• Follow up with insurance carriers via payer portals and calls to resolve outstanding claims and expedite payment.
• Manage both in-network and out-of-network claims, including No Surprises Act timelines and requirements.
• Prioritize aged receivables and high-dollar accounts with accurate documentation and notes.
• Review denials related to medical records requests, EDI rejections, coding issues, and payer processing rules.
• Partner with internal teams to ensure claims are worked accurately and consistently.
• Maintain patient and company confidentiality with clear, up-to-date documentation.

Skills

Medical billing

Denials management

AR follow-up

EOB interpretation

Payer follow-up

No Surprises Act

CMS-1500/UB-04

Tools

TriZetto clearinghouse

Payer portals

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 identification through resolution.

Day-to-Day Responsibilities

• Work a blend of AR follow-up, denials management, and medical collections based on daily claim volume, aging, and dollar amount.
• Review, interpret, and troubleshoot EOBs to identify claim issues, underpayments, denials, missing documentation, coding-related concerns, and payer-specific requirements.
• Follow up with insurance carriers through payer portals and phone calls to resolve outstanding claims and expedite payment.
• Manage both in-network and out-of-network claims, including claims impacted by No Surprises Act timelines and requirements.
• Prioritize aged receivables and high-dollar accounts while maintaining accurate documentation and claim notes.
• Review denials related to medical records requests, EDI rejections, coding issues, and payer processing rules.
• Partner with internal team members and trainers to ensure claims are worked accurately and consistently within department standards.
• Maintain patient and company confidentiality while ensuring all documentation is clear, accurate, and up to date.

REQUIRED SKILLS AND 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 AND 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.

Compensation:

$24 to $27 per hour.

• Medical, Dental, Vision, Life, HSA and Long-Term Disability insurance
• 401k and Profit sharing
• Paid Time Off
• Contribution to Health Benefits
• Company Discounts on Products & Services