Medical Claims Analyst

We are looking for a Medical Claims Analyst to support leave and medical claims operations for a healthcare-focused organization in Minneapolis, Minnesota. This Contract position is ideal for someone with experience evaluating leave-related documentation, interpreting benefit eligibility, and managing claims with accuracy and timeliness. The person in this role will coordinate medical certification, assess payment responsibilities between employer and state programs, and help ensure consistent claim outcomes through detailed review and follow-up.

Responsibilities:
• Manage a daily workload of upcoming leave cases, ensuring each request is reviewed promptly and moved through the claims process efficiently.
• Obtain and evaluate medical documentation from healthcare providers to confirm eligibility and support leave determinations.
• Calculate benefit amounts and determine the appropriate financial responsibility between employer-sponsored programs and applicable state benefits.
• Examine leave and medical claims thoroughly to make informed approval or denial decisions based on documentation and policy guidelines.
• Maintain accurate claim records and status updates within ServiceNow and Workday to support visibility and compliance.
• Respond to issues involving incomplete, disputed, or rejected claims by investigating details and coordinating next steps.
• Partner with internal stakeholders and benefits-related teams to resolve claim questions and maintain smooth leave administration.
• Monitor claim activity for adherence to established procedures, deadlines, and documentation standards.

Qualifications:

• At least 3 years of experience handling medical claims, leave administration, or related insurance benefits work.
• Demonstrated ability to review leave requests and medical leave documentation with a high level of accuracy.
• Experience calculating benefit payments and interpreting coverage or eligibility guidelines.
• Familiarity with claim decision-making, including approvals, denials, and resolution of rejected claims.
• Working knowledge of unemployment, medical, or insurance-related claims processes is preferred.
• Hands-on experience using Workday HCM and the ServiceNow platform in a claims or case management environment.
• Strong organizational skills with the ability to manage a queue-based workload and meet time-sensitive deadlines.

Compensation

$24.70-$28.60 Hourly

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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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