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Claims Processor I Pgba Jobs (NOW HIRING)

Medical University of South Carolina

Claims Processor I

$17.50 - $22/hr

Claims Processor I Claims Processor I Location: South Carolina Summary Under general supervision assures accurate and timely insurance claim processing to include resolving claim edits and paper ...

Medical University of South Carolina

Claims Processor I

$17.50 - $22/hr

Claims Processor I Claims Processor I, South Carolina Summary Under general supervision assures accurate and timely insurance claim processing to include resolving claim edits and paper claims for ...

Magellan Health, Inc.

Claims Processor I

Frisco, TX · On-site

$34K - $51K/yr

General Job Information Title Claims Processor I Grade 18 Work Experience - Required Claims Work Experience - Preferred Education - Required GED, High School Education - Preferred License and ...

AllCare Health

Certified Claims Processor I

Grants Pass, OR · On-site

$16.50 - $21/hr

Certified Claims Processor I Certified Claims Processor I at AllCare Health with the Claims department in Grants Pass, Oregon. We are seeking qualified candidates to join our team! AllCare Health ...

Ourhrconnect

Claims Processor I

Florence, SC · On-site

$16.50 - $20.75/hr

Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes. * Resolves system edits, audits ...

MUSC

Summary Under general supervision assures accurate and timely insurance claim processing to include resolving claim edits and paper claims for submittal. Resolves denied/unpaid insurance claims in a ...

Moda Health

Inpatient Claims Processor I

Milwaukie, OR · On-site

High School diploma or equivalent. * 1-2 years medical claims processing experience. * 10-key proficiency of 135 wpm. * Type a minimum of 35 wpm. * Knowledge of medical terminology, CPT codes and ICD ...

Moda Health

Dental Claims Processor I

Milwaukie, OR · Remote

$17.34 - $18.36/hr

Make corrections as necessary and process claims according to processing policies and contract provisions. Pay Range $17.34- $18.36 ​​​hourly (depending on experience) **Actual pay is based on ...

CareFirst

Claims Processor I (Remote)

Baltimore, MD · Remote

$17 - $21.25/hr

The Claims Processor also use automated system processes to send pending claims to ensure accurate completion according to medical policy, contracts, policies and procedures allowing timely ...

Moda Health

Dental Claims Processor I

Milwaukie, OR · Remote

Make corrections as necessary and process claims according to processing policies and contract provisions. This is a hybrid position based in Milwaukie Oregon. Pay Range $17.34- $18.36 hourly ...

MUSC

$17.50 - $22/hr

Summary Under general supervision assures accurate and timely insurance claim processing to include resolving claim edits and paper claims for submittal. Resolves denied/unpaid insurance claims in a ...

Moda Health

Medical Claims Processor I

Milwaukie, OR · Hybrid

$17.34 - $19.41/hr

Reviews Policies and Procedures (P&P'S) for process instructions to ensure accurate and efficient claims processing as well as providing suggestions for potential process improvements. * Performs all ...

TEKsystems

Claims Processor

Fresno, CA · Remote

$20 - $22/hr

Claims Processor I Location: Fresno, CA Work Arrangement: Remote after successful completion of onsite training Overview We are seeking a detail-oriented Claims Processor I to join a growing health ...

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Moda Health

Medical Claims Processor I

Milwaukie, OR · On-site

Reviews Policies and Procedures (P&P'S) for process instructions to ensure accurate and efficient claims processing as well as providing suggestions for potential process improvements. * Performs all ...

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Claims Processor I Pgba information

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How much do claims processor i pgba jobs pay per hour?

As of Jul 29, 2026, the average hourly pay for claims processor i pgba in the United States is $19.16, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $20.67 per hour, depending on experience, location, and employer.

What is the difference between Claims Processor I Pgba vs Claims Processor II?

AspectClaims Processor I PgbaClaims Processor II
Required CredentialsHigh school diploma or equivalent; basic insurance knowledgeHigh school diploma; some experience or certification preferred
Work EnvironmentEntry-level, clerical setting within insurance companiesMore complex claims processing, possibly supervisory tasks
Employer & Industry UsageCommon in insurance companies, healthcare providersUsed in similar settings, often with increased responsibilities

The main difference between Claims Processor I Pgba and Claims Processor II lies in experience and responsibilities. Claims Processor II typically handles more complex claims and may assist or supervise Claims Processor I Pgba roles. Both positions require similar credentials but differ in scope and expertise.

What does a Claims Processor I PGBA do?

A Claims Processor I PGBA is responsible for reviewing, processing, and adjudicating insurance claims in accordance with company policies and industry regulations. They verify the accuracy of information, determine eligibility, and ensure claims are processed efficiently and correctly. This entry-level position often involves communicating with policyholders, healthcare providers, and other stakeholders to resolve discrepancies or gather additional information. Attention to detail and knowledge of insurance procedures are essential for success in this role.

What are the key skills and qualifications needed to thrive as a Claims Processor I PGBA, and why are they important?

To thrive as a Claims Processor I PGBA, you need strong attention to detail, analytical skills, and a high school diploma or equivalent. Familiarity with claims processing software, data entry systems, and knowledge of insurance or healthcare terminology are typically required. Exceptional organizational skills, time management, and effective communication set top performers apart. These abilities ensure accurate and timely processing of claims, reducing errors and supporting customer satisfaction in a high-volume environment.

What are some common challenges faced by a Claims Processor I at PGBA, and how can they be successfully managed?

Claims Processors at PGBA often encounter challenges such as high volumes of claims, strict accuracy requirements, and tight deadlines. Successfully managing these involves strong attention to detail, effective time management, and familiarity with claims processing software. Collaboration with team members and clear communication with supervisors can help resolve complex cases efficiently. Continuous learning about updated policies and procedures also plays a key role in overcoming daily obstacles.
More about Claims Processor I Pgba jobs
What cities are hiring for Claims Processor I Pgba jobs? Cities with the most Claims Processor I Pgba job openings:
What states have the most Claims Processor I Pgba jobs? States with the most job openings for Claims Processor I Pgba jobs include:
What job categories do people searching Claims Processor I Pgba jobs look for? The top searched job categories for Claims Processor I Pgba jobs are:
Claims Processor I Pgba jobs near you
Infographic showing various Claims Processor I Pgba job openings in the United States as of July 2026, with employment types broken down into 90% Full Time, 8% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $39,863 per year, or $19.2 per hour.

Claims Processor I

Medical University of South Carolina

Remote

$17.50 - $22/hr

Other

Posted 6 days ago

Job description

Claims Processor I

Claims Processor I

Location: South Carolina

Job Description Summary

Under general supervision assures accurate and timely insurance claim processing to include resolving claim edits and paper claims for submittal. Resolves denied/unpaid insurance claims in a timely manner

Job Description

  • Account maintenance: Updating registration, authorization issues, identifying charge correction, processing adjustments as needed and denial follow up according to payer rules and departmental policies.
  • Use electronic billing system appropriately to follow up on outstanding denied claims and all no response claims. Corrects claims in electronic billing system for missing or invalid insurance or patient information according to procedures, and places account on hold if you can't resolve
  • Follow up on denied or no response claims by calling third party payers or using payer websites. Gathering information from patients or other areas to resolve outstanding denied or no response claims. Researching accounts to take appropriate action necessary to resolve.
  • Keep management aware of issues and trends to enhance operations and escalates slow-pay issues to managerial level when necessary.
  • Uses payer websites to stay current on payer rules and changes to include reading newsletters and communicating payer/claim issues and trends.
  • Maintains 95% quality standards on account follow and activity.
  • Maintains productivity standard as set forth by management team.
  • Other duties as assigned.

Additional Job Description

Education: High School Degree or Equivalent Work Experience: 0-6months

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees.

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