Medical Claims Repricer I

Medical Claims Repricer I USA Managed Care Organization West Lake Hills, TX Job Details Full-time $20 - $30 an hour 13 hours ago Benefits Health insurance Dental insurance 401(k) Paid time off Career development plan Vision insurance Opportunities for advancement Qualifications Computer operation Medical claims High school diploma or GED Attention to detail Computer skills Full Job Description Medical Claims Repricer I USA Managed Care Organization (USA MCO) - Austin, TX Full-Time | In-Office | Monday-Friday About Us USA Managed Care Organization (USA MCO) is a leader in providing nationwide healthcare access with a focus on helping control the rising cost of healthcare while respecting providers' authority in patient treatment. Our Health and Wellness Network is the nation's largest, self-developed, privately held Preferred Provider Organization, serving millions of covered lives. We are currently seeking a Medical Claims Repricer I to join our growing Claims Repricing team. This is a paperless processing role with minimal phone activity and strong career growth potential. We highly value candidates with medical claims repricing experience; however, we also welcome motivated, detail-oriented individuals who are eager to learn and grow into a successful Repricer through training and hands-on development. Position Summary The Medical Claims Repricer I is responsible for reviewing and repricing medical claims for procedural, contractual, and pricing accuracy while meeting production and quality standards. This role works closely with multiple departments, as claims repricing is a key function that supports organization-wide operations. Key Responsibilities Maintain strict compliance with HIPAA, confidentiality, and security standards Reprice medical claims using HCFA and UB forms with focus on accuracy and contract compliance Meet established production and quality performance metrics Collaborate with internal departments to support cross-functional workflows and repricing operations Participate in cross-training to broaden repricing and operational knowledge Assist with occasional overtime based on claim volume and turnaround needs Perform additional duties as assigned

Qualifications Required:

High School Diploma or GED Strong computer skills and ability to learn multiple systems High attention to detail and accuracy Professional communication and teamwork skills Reliable, coachable, and growth-oriented mindset Preferred (but not required): 2+ years of recent medical claims processing or repricing experience Experience with ICD/CPT coding PPO / Group plan experience in a multi-tenant environment AS400 / iSeries experience Candidates without direct repricing experience but with strong analytical ability and willingness to learn are encouraged to apply.

Work Environment & Schedule Location:

Austin, TX (This is a full-time, in-office role)

Schedule:

Monday - Friday, 8:00 AM - 4:30 PM CT (37.5 hours/week, 1-hour lunch) Business Casual dress code Company laptop provided Why Join USA MCO? Stable and growing organization Career development and advancement opportunities Hands-on training and cross-department exposure Team-oriented, professional environment

Job Type:

Full-time Pay:

$20.00 - $30.00 per hour

Benefits:

401(k) Dental insurance Health insurance Paid time off Vision insurance Application Question(s): What are your pay expectations

Experience:

recent medical claims-processing : 2 years (Preferred) Ability to

Commute:

West Lake Hills, TX 78746 (Required)

Work Location:

In person