Medical Bill Review Analyst

MARATHON STAFFING GROUP; Carson City (NV); On-site; USD 34,000 - 55,000; Part time

Job summary

MARATHON STAFFING GROUP seeks a detail-oriented Medical Claims Pricing Analyst to review claims, apply pricing methodologies, and ensure compliance with fee schedules and contractual requirements. The role emphasizes accuracy, thorough documentation, and analytical problem-solving within complex healthcare billing data.

Responsibilities include reviewing CPT/ICD-10 codes, investigating pricing discrepancies, and supporting claim adjudication while maintaining pricing integrity across systems.

Qualifications

• High school diploma or GED; coursework or certifications in medical billing are a plus.
• 1–3 years of experience in medical claims processing or revenue cycle operations.
• Strong knowledge of CPT and ICD-10 coding and healthcare billing terminology.
• Familiarity with provider contracts, fee schedules, and reimbursement methodologies.
• Proficiency with claims processing systems, databases, and Excel.
• Excellent analytical, organizational, and problem-solving skills.

Responsibilities

• Review medical claims to ensure pricing accuracy, procedural correctness, and compliance with contractual agreements.
• Apply state fee schedules, usual and customary pricing standards, and other reimbursement methodologies.
• Identify and resolve pricing discrepancies, billing errors, and claim adjustment issues.
• Conduct research on complex claims, reimbursement policies, and claim routing requirements.
• Analyze medical codes and billing information to support accurate claim adjudication.
• Help prevent overpayments and ensure consistency with established pricing rules and guidelines.
• Maintain accurate records and documentation related to claim reviews and adjustments.

Skills

Claims processing

Analytical skills

Excel

Attention to detail

Healthcare billing terminology

Problem solving

Education

High school diploma

Related coursework or certifications in medical billing

Tools

Claims processing systems

Databases

Job description

Our client is seeking a detail-oriented Medical Claims Pricing Analyst to help ensure healthcare claims are processed accurately and in accordance with established pricing agreements, fee schedules, and contractual requirements. This role is ideal for someone who enjoys analytical work, problem-solving, and working with complex healthcare billing information to ensure fair and accurate claim payments.

In this position, you will review medical claims, apply appropriate pricing methodologies, investigate billing discrepancies, and support the overall integrity of the claims process. The successful candidate will have a strong understanding of medical billing and coding, excellent attention to detail, and the ability to navigate complex reimbursement guidelines.

This position will be 20 hours a week.

Key Responsibilities

• Review medical claims to ensure pricing accuracy, procedural correctness, and compliance with contractual agreements.
• Apply state fee schedules, usual and customary pricing standards, and other reimbursement methodologies.
• Identify and resolve pricing discrepancies, billing errors, and claim adjustment issues.
• Conduct research on complex claims, reimbursement policies, and claim routing requirements.
• Analyze medical codes and billing information to support accurate claim adjudication.
• Help prevent overpayments and ensure consistency with established pricing rules and guidelines.
• Maintain accurate records and documentation related to claim reviews and adjustments.

Qualifications

• High school diploma or GED required; related coursework or certifications in medical billing, coding, or healthcare administration are a plus.
• One (1) to three (3) years of experience in medical claims processing, health insurance, medical billing, or revenue cycle operations.
• Strong knowledge of CPT, ICD-10, and healthcare billing terminology.
• Familiarity with provider contracts, fee schedules, and reimbursement methodologies.
• Proficiency with claims processing systems, databases, and Microsoft Excel.
• Excellent analytical, organizational, and problem-solving skills.
• Ability to work independently while maintaining a high level of accuracy and attention to detail.

If you\'re looking for an opportunity to apply your healthcare billing expertise in a meaningful and analytical role, this position offers the chance to make a direct impact on the accuracy and integrity of the claims process.

Marathon Staffing is an Equal Opportunity Employer and participates in E-Verify.

INDC