Part-Time Medical Claims Pricing 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

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.