Claims Analyst

Radiology is the second most used healthcare service, used by over 51% of the workforce annually. Despite the critical role of radiology in healthcare, the process for undergoing a medical imaging exam has remained unchanged for decades. OneImaging is solving this with a concierges approach and a premium-quality radiology network of over 4,000 vetted providers across 48 states, which also reduces imaging costs by 60-80%. Our solution helps patients and families access essential radiology services at fair prices and without surprise bills, all while delivering immediate savings and ROI for employers and payers on every exam.

As a Claims Analyst at OneImaging, you will play a vital role in reviewing, analyzing, and processing healthcare claims to ensure accuracy, compliance with policy guidelines, and timely reimbursement. You will be instrumental in driving financial accuracy and operational efficiency by conducting detailed claim reviews, identifying denial trends or errors, and generating reports to support data-driven decision-making and process improvement.

Success in this role requires a keen eye for detail, strong analytical thinking, and excellent problem-solving skills. You will work independently in a fast-paced environment, manage claim workflows, communicate effectively with cross-functional teams and external partners, and contribute to the ongoing optimization of the revenue cycle.

Key Responsibilities

• Review and analyze claims for accuracy, completeness, and compliance with payer and regulatory guidelines.
• Edit and submit claims in a timely and compliant manner to ensure prompt reimbursement.
• Investigate and resolve claim discrepancies, denials, and appeals efficiently and thoroughly.
• Monitor claims workflow to ensure claims are processed, submitted, and reimbursed within established timelines.
• Manage and support claim generation systems to ensure effective and efficient claim submission processes.
• Apply correct CPT, HCPCS, ICD-10, and other standardized codes in line with billing and coding standards.
• Collaborate with internal teams and external vendors to resolve complex claim issues.
• Prepare, analyze, and interpret reports on claim data, trends, and key performance indicators (KPIs) to identify potential issues and opportunities for improvement.
• Recommend and support implementation of process improvements to increase claims accuracy, reduce rework, and enhance overall efficiency.

Qualifications

• Minimum of 5 years of experience in healthcare claims processing and analysis.
• Strong knowledge of healthcare billing, coding standards, and insurance policies.
• Proficiency with claims systems and technical tools supporting revenue cycle operations.
• Demonstrated ability to work independently and manage time effectively in a fast-paced environment.
• Analytical mindset with experience using data to drive insights and improvements.
• Exceptional attention to detail and accuracy.
• Strong problem-solving and critical thinking skills.
• Ability to build scalable processes and manage ambiguity in a growing organization.
  

Preferred

• Associate's or Bachelor's degree in Healthcare Administration, Business, or a related field
• Familiarity with healthcare IT systems, EHR platforms, or revenue cycle management software.

• Competitive salary and benefits
• Comprehensive health, dental, and vision insurance
• Flexible work schedule and remote work options
• Opportunities for professional development and career growth

OneImaging is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.