Owning the day-to-day integrity of claims and adjudication workflows, the full-time remote Lead Claims Analyst will review and validate imaging claims, manage denials, and develop reporting processes to ensure accurate billing and compliance. Key responsibilities Review, validate, and adjudicate imaging claims against benefit designs and contracted rates, resolving discrepancies proactively Investigate root causes of denials and underpayments, driving appeals and building analyses to address denial patterns Develop and maintain dashboards and KPIs from claims data to provide real-time insights into accounts receivable and claims aging Required qualifications 4+ years in healthcare claims, revenue cycle, or medical billing with experience in complex adjudication and denials Hands-on experience with EDI transactions (837/835) and familiarity with a clearinghouse platform, preferably Waystar Strong understanding of CPT/HCPCS, ICD-10, and cost-sharing mechanics in radiology/imaging Advanced spreadsheet skills for building reporting from raw claims data A meticulous, audit-minded approach to tracing and defending financial transactions
Lead Claims Analyst in workfromhome at Unknown Company
This position is listed as contract and able to be worked remotely.