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Health Insurance Claims Processor Jobs (NOW HIRING)

Highmark Health

$27.42/hr

Reviews processed claims and inquiries to determine corrective action including adjusting claims as ... In connection with this, all employees must comply with both the Health Insurance Portability ...

Aston Carter

Claims Processor

Omaha, NE · On-site

$20 - $22/hr

Skills Data entry, Customer service, Claim, Claims processing, Insurance, Health insurance Top Skills Details Data entry,Customer service Additional Skills & Qualifications 1+ years of Data Entry ...

KARNA LLC

$20 - $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 ...

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 ...

KARNA LLC

$20 - $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 ...

Datamark, Inc.

Medical Claims Processor

El Paso, TX

$16.50/hr

Team as a Medical Claims Processor! Are you looking for an exciting opportunity where your ... Health Care Plan (Medical, Dental & Vision) * Retirement Plan (401k, IRA) * Life Insurance (Basic ...

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY

$18.75 - $23.75/hr

Process and evaluate hospital claims manually or through claims work flow * Validate information ... health insurance or benefits environment required * Basic keyboarding skills required * Strong ...

Datamark, Inc.

Medical Claims Processor

El Paso, TX · On-site

$16.50/hr

Team as a Medical Claims Processor! Are you looking for an exciting opportunity where your ... Health Care Plan (Medical, Dental & Vision) * Retirement Plan (401k, IRA) * Life Insurance (Basic ...

Datamark, Inc.

Medical Claims Processor

El Paso, TX · On-site

$16.50/hr

Team as a Medical Claims Processor! Are you looking for an exciting opportunity where your ... Health Care Plan (Medical, Dental & Vision) * Retirement Plan (401k, IRA) * Life Insurance (Basic ...

Conduent, Inc.

Remote Claims Processor

VA · Remote

$15/hr

Remote Claims Processor Schedule: Flexible shifts between 6:00 AM - 10:30 PM (based on business ... In addition, Conduent provides a variety of benefits to employees including health insurance ...

Conduent, Inc.

Remote Claims Processor

VA · Remote

$15/hr

Remote Claims Processor Schedule: Flexible shifts between 6:00 AM - 10:30 PM (based on business ... In addition, Conduent provides a variety of benefits to employees including health insurance ...

Conduent, Inc.

Remote Claims Processor

Chesapeake, VA · On-site +1

$15/hr

Remote Claims Processor Schedule: Flexible shifts between 6:00 AM - 10:30 PM (based on business ... In addition, Conduent provides a variety of benefits to employees including health insurance ...

Conduent, Inc.

Remote Claims Processor

Chesapeake, VA · On-site +1

$15/hr

Remote Claims Processor Schedule: Flexible shifts between 6:00 AM - 10:30 PM (based on business ... In addition, Conduent provides a variety of benefits to employees including health insurance ...

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Health Insurance Claims Processor information

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

As of Jun 1, 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 are the key skills and qualifications needed to thrive as a Health Insurance Claims Processor, and why are they important?

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.

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.

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 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.

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 May 2026, with employment types broken down into 1% As Needed, 79% Full Time, and 20% Part Time. Highlights an 75% Physical, and 25% Hybrid job distribution, with an average salary of $46,461 per year, or $22.3 per hour.
Senior Claims Processor

Senior Claims Processor

Highmark Health

$27.42/hr

Full-time

Posted 6 days ago

Highmark Health rating

7.8

Company rating: 7.8 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

Job description

Company :
Highmark Inc.Job Description :
JOB SUMMARY
This job is responsible for screening, reviewing, evaluating online entry, correcting errors and/or performing quality control review and final adjudication of paper/electronic claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Reviews processed claims and inquiries to determine corrective action including adjusting claims as necessary and takes the corrective action steps using enrollment, benefit and historical claim processing information; may coordinate benefits and interact with customers. Responsible for the timely and accurate completion of claims adjustments which could be a result of internal/external audits, member/provider phone calls, other insurance information received, appeals, and system changes, etc.; provides technical assistance in researching and resolving inquiries.
ESSENTIAL RESPONSIBILITIES
  • Receives and processes complex claims to include entering/verifying claims data; determines if claim information is complete and correct.
  • Resolves claim edits, reviews history records and determines benefit eligibility for service. Reviews payment levels to arrive at final payment determination.
  • Meets all production and quality standards, ensuring timeliness and accuracy of all work given by support staff/management. Maintains accurate records, including timekeeping records and attends all required training classes.
  • Elevates issues to next level of supervision as appropriate and ensures a professional line of communication is maintained with internal and external customers.
  • Other duties as assigned or requested.
EDUCATION
Required
  • High School Diploma/GED
Substitutions
  • None
Preferred
  • None
EXPERIENCE
Required
  • 3 years of related experience
  • 1 year of claims processing experience
Preferred
  • Inquiry resolution system, OCWA, Oscar, Outlook experience
  • Knowledge to research and handle complex claims
LICENSES or CERTIFICATIONS
Required
  • None
Preferred
  • None
SKILLS
  • Strong verbal and written communication skills.
  • Ability to take direction and to navigate through multiple systems simultaneously.
  • Knowledge of administrative and clerical procedures and systems such as word processing and managing files and records.
  • Ability to use mathematics to adjudicate claims.
  • Ability to solve problems within pre-defined methods and guidelines.
  • Knowledge of operating systems specific to claim processing.
  • Ability to thoroughly read guidelines ensuring claim accuracy and following directions.
  • Knowledge to research and handle complex claims.
  • Ability to assist with lead functions.
  • Ability to assist with questions from the claims processors/other teams.

Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Never
Travel regularly from the office to various work sites or from site-to-site
Never
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Never
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$19.66
Pay Range Maximum:
$27.42
Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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About Highmark Health

Sourced by ZipRecruiter

A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best. Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia, and eastern and northwestern New York with customers in 50 states and the District of Columbia. We passionately serve individual consumers and fellow businesses alike. And our companies cover a diversified spectrum of essential health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions. Our financial position reflects strength and stability, with our year-end 2022 consolidated revenues totaling $26 billion. And we're proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.

Industry

Health care and social assistance and insurance services

Company size

10,000+ Employees

Headquarters location

Pittsburgh, PA, US

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