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Billing Adjudicator Jobs (NOW HIRING)

MedWiz Pharmacy

LTC Data Entry Tech

Woodridge, IL · On-site

$16.75 - $20/hr

Framework LTC experience * Long Term Care billing/ adjudication experience * Familiar with Medical Terminology * Have a basic understand of Illinois Pharmacy Law Job Specifications: * Full- time ...

Medix

PBM Biller

Irvine, CA · On-site

$25 - $27/hr

The primary responsibilities include PBM billing, claim adjudication, managing authorizations, and processing co-pays while verifying eligibility. This role is crucial for ensuring accurate billing ...

MedWiz Pharmacy

LTC Data Entry Tech

Woodridge, IL · On-site

$16.75 - $20/hr

Framework LTC experience * Long Term Care billing/ adjudication experience * Familiar with Medical Terminology * Have a basic understand of Illinois Pharmacy Law Job Specifications: * Full- time ...

MedWiz Pharmacy

LTC Data Entry Tech

Woodridge, IL · On-site

$16.75 - $20/hr

Framework LTC experience * Long Term Care billing/ adjudication experience * Familiar with Medical Terminology * Have a basic understand of Illinois Pharmacy Law Job Specifications: * Full- time ...

Quest Diagnostics

Billing Coordinator II

PA · On-site

$17.20/hr

Billing Coordinator II - West Norriton, PA, Monday to Friday, Between 7:00AM to 6:00PM Eastern You ... Conducts data entry and re-work for adjudication of claims. * Works on various other projects as ...

Stryker Corporation

Medical Billing Director

Medford, OR · On-site

$100 - $125/hr

... adjudication and payment resolution. The Medical Billing Director develops and implements policies, procedures, workflows, and system improvements that promote operational efficiency, billing ...

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Billing Adjudicator information

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How much do billing adjudicator jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for billing adjudicator in the United States is $20.79, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $21.88 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a billing adjudicator, and why are they important?

To thrive as a Billing Adjudicator, you need strong analytical skills, attention to detail, and knowledge of medical billing and insurance claims processes, often supported by an associate degree or relevant certification. Familiarity with claims management software, electronic health record (EHR) systems, and coding standards like ICD-10 and CPT is typically required. Excellent communication, problem-solving abilities, and organizational skills help address discrepancies and interact effectively with providers and insurers. These competencies ensure accurate claims processing, reduce errors, and facilitate timely reimbursement within healthcare or insurance organizations.

What skills are needed for claim adjudication?

Billing Adjudicators need strong attention to detail, analytical skills, and knowledge of insurance policies and billing procedures. Proficiency with claims processing software and good communication skills are also important for reviewing and resolving claims efficiently.

What is a billing adjudicator?

Billing Adjudicators are professionals responsible for reviewing, evaluating, and processing insurance claims or billing disputes in healthcare, insurance, or related fields. They analyze submitted claims for accuracy, verify eligibility, ensure compliance with relevant policies, and determine the appropriate payment or denial. Their role helps ensure that payments are made correctly and in accordance with regulations and contractual agreements. Billing Adjudicators often work closely with healthcare providers, insurance companies, and patients to resolve billing issues.

What are some common challenges a billing adjudicator faces when reviewing and processing claims?

A Billing Adjudicator often encounters challenges such as interpreting complex insurance policies, identifying discrepancies in claims data, and ensuring compliance with ever-changing regulations. Staying updated on the latest payer guidelines and efficiently handling large volumes of claims while maintaining accuracy can also be demanding. Collaboration with other departments, such as coding and compliance teams, is essential to resolve claim discrepancies and improve workflow. Strong attention to detail and effective communication skills are key to overcoming these challenges.

What is the difference between Billing Adjudicator vs Claims Processor?

AspectBilling AdjudicatorClaims Processor
CredentialsTypically requires insurance or healthcare billing certificationsOften requires similar certifications, such as medical billing or claims processing
Work EnvironmentHealthcare or insurance companies, hospitals, or clinicsInsurance companies, healthcare providers, or third-party claims organizations
Job FocusReviewing and validating billing claims for accuracy and complianceProcessing and adjudicating insurance claims for payment

The main difference between a Billing Adjudicator and a Claims Processor lies in their focus: Billing Adjudicators primarily review and validate billing claims for accuracy, while Claims Processors handle the initial processing and adjudication of insurance claims. Both roles require similar certifications and are found in healthcare and insurance settings, but their specific responsibilities differ slightly.

More about Billing Adjudicator jobs
What job categories do people searching Billing Adjudicator jobs look for? The top searched job categories for Billing Adjudicator jobs are:
Billing Adjudicator jobs near you
Infographic showing various Billing Adjudicator job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 83% Full Time, 11% Part Time, and 4% Contract. Highlights an 90% Physical, 4% Hybrid, and 6% Remote job distribution, with an average salary of $43,233 per year, or $20.8 per hour.

Epic Revenue Cycle Application Analyst (Hospital Billing & Professional Billing)

InterScripts, Inc

Chantilly, VA • On-site

$46K - $62K/yr

Full-time

Posted 8 days ago

Job description


Epic Revenue Cycle Application Analyst (Hospital Billing & Professional Billing)
Location: Chantilly, Virginia, United States
Experience:Years
Employment Type: Full Time
Job Summary
We are seeking an experienced Epic Revenue Cycle Application Analyst (Hospital Billing & Professional Billing) to join our healthcare IT team. The ideal candidate will have hands-on experience in implementing, configuring, supporting, and optimizing Epic Revenue Cycle applications, with expertise in Resolute Hospital Billing (HB) and Resolute Professional Billing (PB). The candidate will collaborate with revenue cycle, finance, billing, coding, and operational teams to enhance billing accuracy, claims processing, reimbursement, and overall revenue cycle performance.
Key Responsibilities
  • Configure, maintain, and support Epic Revenue Cycle applications, including Resolute Hospital Billing (HB) and Resolute Professional Billing (PB).
  • Gather, analyze, and document business requirements from revenue cycle, finance, billing, and operational stakeholders.
  • Design, build, test, validate, and deploy Epic Revenue Cycle enhancements and system changes.
  • Support end-to-end revenue cycle workflows, including charge capture, billing, claims management, payment posting, reimbursement, denials management, and collections.
  • Configure billing rules, claim edits, work queues, reimbursement settings, and financial workflows.
  • Troubleshoot production issues, perform root cause analysis, and implement system improvements.
  • Participate in Epic implementations, upgrades, optimization initiatives, and enhancement projects.
  • Execute unit testing, integrated testing, and User Acceptance Testing (UAT).
  • Develop and maintain build documentation, workflow diagrams, technical specifications, and support documentation.
  • Collaborate with other Epic analysts to ensure seamless integration with Patient Access, Cadence, Prelude, MyChart, and other Epic applications.
  • Ensure all solutions comply with Epic best practices, payer requirements, and healthcare regulatory standards.

Requirements
  • 3+ years of hands-on experience with Epic Revenue Cycle applications, including Resolute Hospital Billing (HB) and Resolute Professional Billing (PB).
  • Epic Resolute Hospital Billing (HB) and/or Epic Resolute Professional Billing (PB) Certification is mandatory.
  • Experience in Epic build, configuration, implementation, testing, and production support.
  • Strong understanding of U.S. healthcare revenue cycle operations, hospital billing, physician billing, claims processing, reimbursement, payment posting, and denials management.
  • Experience supporting integrated Epic applications.
  • Excellent analytical, troubleshooting, and problem-solving skills.
  • Strong verbal and written communication skills.
  • Ability to work independently and collaboratively in a fast-paced healthcare environment.

Mandatory Requirements
  • Epic Resolute Hospital Billing (HB) and/or Professional Billing (PB) Certification (Mandatory)
  • Minimum 3 years of relevant Epic Revenue Cycle experience
  • Hands-on experience with Hospital Billing (HB) and Professional Billing (PB) workflows.
  • Excellent communication skills.

Preferred Skills
  • Experience in U.S. healthcare revenue cycle and financial operations.
  • Knowledge of charge capture, claims adjudication, payment posting, denials management, reimbursement, and collections.
  • Experience integrating Epic Revenue Cycle applications with Patient Access, Cadence, Prelude, MyChart, and other Epic modules.
  • Understanding of Epic implementation methodology and healthcare interoperability.
  • Familiarity with HIPAA compliance and healthcare financial regulations.
  • Strong documentation, stakeholder management, and communication skills.

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