Clinical Analyst

SmartLight Analytics

Clinical Analyst at healthcare company reviewing claims, analyzing data for billing accuracy, and communicating findings to teams.

Posted 4/28/2026full-timeRemote • 🇺🇸 United StatesJuniorMid-LevelWebsite

About the role

Key responsibilities & impact

Review medical claims and related medical records to check for billing accuracy and potential savings opportunities.
Assist in identifying issues that may lead to improper payments across professional, facility, and member claims.
Analyze data to identify trends or patterns that may indicate billing or payment concerns.
Use internal and external systems to research claim information and support payment resolution efforts.
Document findings clearly, including identified issues, trends, and recommended next steps.
Support the review of claims associated with possible overpayments based on benefits or policy guidelines.
Communicate findings to internal teams and carrier partners in a clear and professional manner.

Requirements

What you’ll need

Bachelor’s degree in healthcare or a related field preferred.
At least one of the following certifications: RN, CPC, CCS, or similar clinical/coding credential.
2-3 in TPA/Carrier claims processing or payment integrity related areas.
2–3 years of experience in healthcare administration, billing, claims processing, clinical auditing, payment integrity, or related areas.
Working knowledge of medical claims data, medical procedures, and healthcare workflows.
Experience working with commercial health plans is a plus.
Solid analytical and critical‑thinking skills.

Benefits

Comp & perks

Health insurance
Flexible work arrangements
Professional development

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

medical claims processingbilling accuracydata analysispayment integrityclinical auditingtrend identificationissue resolutiondocumentationhealthcare workflowscommercial health plans

Soft Skills

analytical skillscritical-thinking skillscommunication skillsprofessionalism

Certifications

RNCPCCCS