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Medical Claims Analyst

1-2 years
Not Disclosed
10 Sept. 24, 2025
Job Description
Job Type: Full Time Education: B.Sc/M.Sc/M.Pharma/B.Pharma/Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Job Title: Medical Claims Analyst

Req ID: 2085
Location: Chennai, Tamil Nadu, India
Posted On: Thursday, September 4, 2025
Status: This job posting is no longer available


Job Purpose

The Medical Claims Analyst is responsible for collections, account follow-up, billing, and allowance posting for assigned accounts, ensuring timely resolution and accuracy of claims.


Duties and Responsibilities

  • Follow up with payers via phone, email, fax, or websites to ensure timely resolution of all outstanding claims.

  • Meet and maintain daily productivity and quality standards as per departmental policies.

  • Utilize workflow systems, client host systems, and other tools to collect payments and resolve accounts.

  • Adhere to established client/team policies and procedures.

  • Maintain knowledge of timely filing deadlines for each designated payer.

  • Perform research regarding payer-specific billing guidelines as needed.

  • Analyze, identify, and resolve issues causing payer payment delays.

  • Identify and trend claims issues to proactively reduce denials.

  • Communicate issues and/or trends to management.

  • Initiate and manage appeals when necessary.

  • Identify and correct medical billing errors.

  • Send accurate appeals with supporting documentation and effective communication to complete recovery.

  • Understand underpayments, overpayments, and credit balance processes.

  • Assist with special accounts receivable (A/R) projects, including analysis and reporting.

  • Act cooperatively and courteously with patients, visitors, co-workers, management, and clients.

  • Work independently from assigned work queues.

  • Maintain confidentiality and a professional attitude at all times.

  • Perform other duties as assigned by management.

  • Use, protect, and disclose patients’ Protected Health Information (PHI) in compliance with HIPAA standards.

  • Comply with Information Security and HIPAA policies and procedures.

  • Limit PHI viewing strictly to the minimum necessary to perform assigned duties.


Qualifications

  • Education: High School diploma or equivalent.

  • Experience:

    • Minimum 1 year of healthcare Accounts Receivable/Collections experience in a BPO setting (claims payment processing, claims status and tracking, medical billing, A/R follow-ups, denials, and appeals).

    • Experience in medical billing and A/R collections.

    • Background in calling payers to verify claim status and resolve payment disputes.

  • Skills:

    • Strong interpersonal and communication skills at all organizational levels.

    • Problem-solving and creative thinking with sound judgment.

    • High integrity, dependability, urgency, and results orientation.

    • Excellent written and verbal communication skills.

    • Gracious and welcoming personality for customer service interactions.


Working Conditions

  • Shift Requirement: Must be amenable to working night shifts.

  • Physical Demands: May require moving around the work area; sitting; performing manual tasks; using office equipment (computers, peripherals, telephones); extending arms; kneeling; talking; and hearing.

  • Mental Demands: Ability to follow directions, collaborate effectively, and handle stress.

  • Work Environment: Typically minimal noise levels.


Equal Opportunity Statement

Med-Metrix is an Equal Opportunity Employer. Discrimination based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information, political affiliation, military service, veteran status, or any other protected characteristic under applicable law is prohibited.