Medical Claims Analyst

Description We are looking for a detail-oriented Medical Claims Analyst to join a team supporting Medicaid audit and claims review activities in Raleigh, North Carolina. This contract opportunity is ideal for someone who can evaluate provider billing practices, examine payment accuracy, and contribute to compliance-focused reviews with growing independence. The role offers the chance to apply analytical judgment, strengthen audit documentation, and help improve the integrity of Medicaid-related claims operations.

Responsibilities:

• Review provider billing records and medical claim activity to identify discrepancies, validate payments, and assess adherence to Medicaid guidelines
• Carry out structured audit procedures for claims, denials, rejected claims, and billing documentation to support program integrity efforts
• Interpret applicable Medicaid requirements and federal regulatory standards when analyzing audit results and determining potential issues
• Develop clear working papers, summaries, and preliminary findings that accurately document testing performed and conclusions reached
• Partner with internal stakeholders to clarify claim exceptions, address audit questions, and support corrective action recommendations
• Analyze medical billing and Medicaid claim data to detect patterns, trends, and areas requiring additional review
• Contribute to compliance examinations involving provider assessments, payment verification, and operational claim review activities Requirements
• 2-5 years of experience in Medicaid, healthcare claims, or audit-related roles
• Hands-on knowledge of medical claims processing, claim denials, rejected claims, and medical billing practices
• Familiarity with Medicaid billing requirements and provider-focused audit or program integrity work
• Ability to evaluate documentation, perform testing, and apply regulatory guidance to support sound conclusions
• Strong analytical skills with the ability to organize findings and maintain thorough audit records
• Effective written and verbal communication skills for presenting issues and collaborating with cross-functional teams
• Proficiency in reviewing claim data and identifying inconsistencies, risks, or compliance concerns Robert Half is the world's first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies.

We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more. 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. © 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking "," you're agreeing to Robert Half's Terms of Use (https://www.roberthalf.com/us/en/terms) and Privacy Notice (https://www.roberthalf.com/us/en/privacy) .