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Health Insurance Claims Processor Jobs (NOW HIRING)

Kelly

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Claims Processor

Springfield, IL · On-site

$17 - $17.75/hr

Are you looking to build your career in healthcare claims processing? Join our team as a Claims ... Solid computer and typing skills * 6+ months of office-clerical, medical, or insurance claims ...

CYNET SYSTEMS

Claims Processor

Mason, OH · On-site

$20 - $22/hr

Efficiently and accurately processes a variety of vision insurance claims or adjustments. * Determines any special plan requirements prior to billing. * Reviews claims before entry for completeness ...

Redeemer Health

Claims Processor

Philadelphia, PA · On-site

$16.25 - $20.50/hr

OVERVIEW Joining Redeemer Health means becoming part of an inclusive, supportive team where your ... insurance payers. Reviews and corrects claim edits identified by Hospital EHR and claim ...

Redeemer Health

Claims Processor

Philadelphia, PA · On-site

$16.25 - $20.50/hr

OVERVIEW Joining Redeemer Health means becoming part of an inclusive, supportive team where your ... insurance payers. Reviews and corrects claim edits identified by Hospital EHR and claim ...

Fifth Third

Claims Processor

Cincinnati, OH · On-site

$16.25 - $20.75/hr

Responsible for completing and filing investor/insurer claims within required guidelines in order ... Claims Processor At Fifth Third, we understand the importance of recognizing our employees for the ...

Medix

Claims Processor

Tampa, FL · On-site

$24 - $30/hr

Review and process healthcare claims for accuracy, completeness, and eligibility. * Enter and ... Term Life Insurance Plan. Required Employment / Compliance Language Medix is an Equal Opportunity ...

Amwins

Claims Processor

Phoenix, AZ

$17 - $21.25/hr

Are you ready to make a meaningful impact in the dynamic world of insurance? Join Amwins Self-Funded as a Claims Analyst . This is an in-office position, that offers the flexibility to work from home ...

Amwins

Claims Processor

Mesa, AZ

$16.75 - $21.25/hr

Are you ready to make a meaningful impact in the dynamic world of insurance? Join Amwins Self-Funded as a Claims Analyst . This is an in-office position, that offers the flexibility to work from home ...

Amwins

Claims Processor

Scottsdale, AZ

$17.25 - $21.75/hr

Are you ready to make a meaningful impact in the dynamic world of insurance? Join Amwins Self-Funded as a Claims Analyst . This is an in-office position, that offers the flexibility to work from home ...

KARNA LLC

$22 - $25/hr

Claims Review and Processing: Analyze and process a variety of complex medical claims in accordance ... Understanding of medical terminology, healthcare services, and insurance procedures (worker ...

Amwins

Claims Processor

Scottsdale, AZ · On-site

$17.25 - $22/hr

Are you ready to make a meaningful impact in the dynamic world of insurance? Join Amwins Self-Funded as a Claims Analyst . This is an in-office position, that offers the flexibility to work from home ...

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Health Insurance Claims Processor information

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$12

$22

$34

How much do health insurance claims processor jobs pay per hour?

As of Aug 4, 2026, the average hourly pay for health insurance claims processor in the United States is $22.34, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $25.48 per hour, depending on experience, location, and employer.

What is the difference between Health Insurance Claims Processor vs Medical Billing Specialist?

AspectHealth Insurance Claims ProcessorMedical Billing Specialist
CredentialsHigh school diploma; certifications like Certified Claims Professional (CCP)High school diploma; certifications like Certified Medical Billing Specialist (CMBS)
Work EnvironmentInsurance companies, healthcare providers, claims departmentsMedical offices, billing companies, healthcare facilities
Primary ResponsibilitiesReview and process insurance claims, ensure accuracy, follow up on denialsPrepare and submit medical bills, verify insurance coverage, manage patient accounts

While both roles involve handling healthcare financial transactions, the Health Insurance Claims Processor primarily focuses on reviewing and processing insurance claims submitted by providers, whereas the Medical Billing Specialist manages the billing process from patient registration to payment collection. Both roles require knowledge of insurance policies and coding, but their daily tasks and work environments differ slightly.

Is a health insurance claims processor job in demand?

Health insurance claims processor jobs are in steady demand due to the ongoing need for healthcare administration and insurance processing. Employment in this field is expected to grow as healthcare coverage expands and companies seek skilled workers familiar with claims software and regulations.

What does a health insurance claims processor do?

A Health Insurance Claims Processor reviews and evaluates insurance claims submitted by policyholders or healthcare providers. They verify the accuracy of the information, ensure that the claims comply with policy terms, and determine the amount payable for each claim. Claims processors may also correspond with providers or claimants for additional documentation, resolve discrepancies, and help prevent fraudulent claims. Their work ensures that claims are processed efficiently and payments are made accurately according to insurance policies.

What are the key skills and qualifications needed to thrive as a health insurance claims processor?

To thrive as a Health Insurance Claims Processor, you need attention to detail, knowledge of insurance policies and medical terminology, and typically a high school diploma or equivalent. Familiarity with claims management software, electronic health record (EHR) systems, and basic coding (ICD-10, CPT) is standard in this role. Strong organizational skills, problem-solving abilities, and effective communication help you manage claims efficiently and resolve discrepancies. These competencies ensure accurate processing, minimize errors, and support timely reimbursement within the healthcare system.

How to become a health insurance claims processor?

To become a health insurance claims processor, candidates typically need a high school diploma or equivalent and should develop skills in data entry, attention to detail, and knowledge of insurance policies. Some employers prefer candidates with postsecondary education or certifications in health insurance or medical billing, and on-the-job training is common. Proficiency with claims processing software and understanding of healthcare terminology are also beneficial.

What are some common challenges health insurance claims processors face, and how can they effectively manage them?

Health Insurance Claims Processors often encounter challenges such as interpreting complex policy language, managing high volumes of claims, and ensuring compliance with changing regulations. To effectively manage these challenges, processors benefit from developing strong attention to detail, staying up to date with industry guidelines, and utilizing time management strategies. Collaboration with other departments such as customer service and medical coding teams is also key to resolving discrepancies and ensuring accurate claim outcomes.
More about Health Insurance Claims Processor jobs
What cities are hiring for Health Insurance Claims Processor jobs? Cities with the most Health Insurance Claims Processor job openings:
What states have the most Health Insurance Claims Processor jobs? States with the most job openings for Health Insurance Claims Processor jobs include:
What job categories do people searching Health Insurance Claims Processor jobs look for? The top searched job categories for Health Insurance Claims Processor jobs are:
Health Insurance Claims Processor jobs near you
Infographic showing various Health Insurance Claims Processor 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 $46,461 per year, or $22.3 per hour.

Insurance Claims Processor I

United Regional Transition Clinic

Wichita Falls, TX • On-site

Full-time

Posted 7 days ago

Job description


Summary of Essential Functions:
  • Files insurance claims on the UB-04 and CMS 1500 form for hospital and physician services.
  • Computes insurance benefits, allowances, adjustments, and patient balances.
  • Processes, traces, and verifies reimbursement from payers, and other payers as assigned.
  • Displays positive customer relations with other departments within the hospital, patients, and insurance companies.
  • Work from home available after 60-90 days of on-the-job training.

Educational Requirements:
  • High school graduate or equivalent.
  • 1 to 2 years billing and/or claims follow-up obtained through related work experience or vocational school preferred.
  • Insurance and medical terminology are helpful.
  • Must be able to communicate effectively in English, both verbally and in writing.

Qualifications/Knowledge/Skills/Abilities:
  • Knowledge in all areas of insurance, including but not limited, the ability to analyze and compile insurance billing data on the UB-04 and CMS 1500 forms.
  • Knowledge of the filing practices for all third-party payers.
  • Ability to compute insurance benefits, allowances, adjustments, and patient balances.
  • Knowledge of the appeal process to government payers, and other payers as assigned.
  • Ability to analyze payment practices of governmental payers, and other payers as assigned.
  • Demonstrate diligence, patience, and persistence to obtain required information on outstanding accounts.
  • Ability to read, comprehend and apply governmental rules and regulations.
  • Ability to utilize tools available (i.e. payer websites).
  • Knowledge of patient accounts and the ability to discuss account information with patients and insurance companies.
  • Basic mathematical knowledge including understanding of debits and credits for correct account transactions.
  • Type 45 w.p.m. ensuring correct spelling and grammar when documenting account actions or written communications.
  • Must have internet access and a secure office space to work from home.
  • Requires the use of office equipment such as computer terminals, telephones and telephone headsets, copiers, 10-key adding machine, and fax machine.

Duties and Responsibilities:
  • Compiles data and prepares insurance claims for billing utilizing patient, hospital and insurance data, and reviews LMRP queries to ensure proper processing.
  • Reviews and corrects/posts appropriate adjustments to patient accounts. Investigates and corrects questionable charges to patient accounts.
  • Processes and traces for hospital and physician claims ensuring timely filing to avoid missing deadlines.
  • Utilize billing process to ensure claims are filed accurately daily. Properly applies the 24/72-hour regulations to ensure compliance.
  • Verifies and calculates hospital and physician payments, follows up on incorrect payments or denials in a timely manner and ensures proper status of accounts.
  • Generate appropriate secondary billing if applicable. Determine whether to re-file a claim, refund, or process an adjustment.
  • Submit written and verbal inquiries to payers in an efficient and professional manner to determine status of claims. Ensure accurate information is included for the payer to identify the claim.
  • Supply payers with requested information for the claim to be processed in a timely manner. Document all information pending from other providers. Follow through on all resources by contacting other providers and inform them of pended claim due to their outstanding claim information. Contacts patients as needed for required information.
  • Demonstrate diligence and persistence with payers while maintaining tact and diplomacy.
  • Notifies management of any consistent discrepancies or potential reimbursement problems.
  • Processes daily reports, mail, e-mails, and phone calls. All mail received is worked within 2 days of receipt and all information is documented in the patients account note file.
  • Identifies Medicare and Medicaid combine messages daily. Responsible for obtaining proper assistance combining accounts.
  • Non-billable report is worked daily ensuring adjustments are posted accurately and timely.
  • Ensure all pertinent information is documented in the patient account note file. Ensure names and phone numbers are documented when applicable. Ensures correct insurance information is maintained and makes changes when necessary.
  • Ensures work queues are reviewed and worked according to expectations.
  • Maintains good working relationships with coworkers and revenue cycle departments.
  • Maintains productivity set forth by department standards.
  • Performs all other tasks/responsibilities as necessary.

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