Healthcare Claims Analyst — Drive Payment Accuracy

Free Market Health; Pittsburgh (Allegheny County); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

Generous PTO

Medical, dental, and vision premiums %

Employer HSA contribution

Paid parental leave

401(k) match

Transit and parking benefits

Flexible, collaborative work环境

Job summary

Free Market Health is hiring a detail-oriented Claims Analyst to join our Pittsburgh HQ onsite. You will ensure accuracy, integrity, and timely processing of healthcare claims, monitor clearinghouse activity, and resolve discrepancies to improve payment outcomes for patients and clients.

Join a collaborative team focused on connecting stakeholders in the specialty pharmacy ecosystem and delivering a high-quality claims experience.

Qualifications

• 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 manage multiple priorities.
• Clear communication skills and the ability to work collaboratively with cross-functional teams.
• Ability to handle sensitive healthcare information with professionalism and discretion.

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.

Skills

Healthcare claims

Attention to detail

Cross-functional collaboration

Problem solving

HIPAA compliance

Education

College degree preferred

Tools

X12 transactions

NCPDP transactions

SQL

Job description

Free Market Health is hiring a detail-oriented Claims Analyst to join our Pittsburgh HQ onsite. You will ensure accuracy, integrity, and timely processing of healthcare claims, monitor clearinghouse activity, and resolve discrepancies to improve payment outcomes for patients and clients.

Join a collaborative team focused on connecting stakeholders in the specialty pharmacy ecosystem and delivering a high-quality claims experience.