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Healthcare Claims Processing Jobs (NOW HIRING)

Molina Healthcare

Adjuster, Claims

Long Beach, CA · On-site

$17.50 - $21.50/hr

Required Qualifications At least 1 year of claims processing experience in a managed care setting ... Preferred Qualifications Health care claims/billing experience. To all current Molina employees: If ...

Independent Living Systems

Claims Auditor

Miami, FL · On-site

By collaborating with claims processors, healthcare providers, and compliance teams, the auditor helps to streamline claims management and reduce errors. Ultimately, this role supports the delivery ...

GDIT

Claims Processing Lead - WTCHP TPA

WV · On-site +1

CMS 1500 Claim Forms, Communication, Healthcare Claims Processing, Health Care Systems, ICD-10 Procedure Coding System Certifications: None Experience: 5 + years of related experience US Citizenship ...

Relation Insurance

Claims Specialist, COE

Tulsa, OK · On-site

WHAT WE'RE LOOKING FOR The Claims Specialist processes and manages claims activities related to the organization's Healthcare Center of Excellence (COE) programs, ensuring accuracy, timeliness, and ...

NTT DATA

Medical Claims Processor - Remote

$18/hr

Correctly calculate claims payable amount using applicable methodology/fee schedule Requirements: * 1-3 year(s) hands-on experience in Healthcare Claims Processing * 2+ year(s) using a computer with ...

VIVA Health

Claims Training Coordinator

Birmingham, AL · Remote

At least 2-5 years in healthcare claims processing, claims operations, or related healthcare administrative role * Experience creating, maintaining, or updating policies, procedures, or technical ...

Northern Base

NASCO claims Specialist

Newark, NJ · On-site

$110K - $115K/yr

Extensive experience in US Healthcare Insurance - NASCO Claims Processing. * Strong understanding of: o Claims lifecycle and adjudication engines o EDI (837, 835, 270/271) o Coding standards: ICD 10, ...

Molina Healthcare

Senior Examiner, Claims

Long Beach, CA · Remote

$18.50 - $23.50/hr

... processing errors. Essential Job Duties Evaluates the adjudication of claims using standard ... Preferred Qualifications Health care claims/billing experience. #PJClaims3 #LI-AC1 To all current ...

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Healthcare Claims Processing information

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How much do healthcare claims processing jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for healthcare claims processing 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 healthcare claims processing?

Healthcare claims processing is the administrative procedure by which insurance companies review and determine whether to pay for medical services provided to patients. This process involves submitting, analyzing, and either approving or denying claims submitted by healthcare providers on behalf of patients. Claims processors verify patient information, check coverage details, and ensure that services are medically necessary and properly documented. Accurate and timely claims processing is essential for both healthcare providers and patients to ensure services are paid for according to insurance policies.

What are some common challenges faced in healthcare claims processing, and how can a new employee prepare to handle them?

Healthcare claims processors often encounter challenges such as interpreting complex insurance policies, identifying errors or discrepancies in submitted claims, and keeping up with frequent regulatory changes. New employees can prepare by developing strong attention to detail, familiarizing themselves with medical terminology, and staying current on industry guidelines. Additionally, effective communication and collaboration with providers, insurers, and team members are key to resolving issues quickly and accurately.

What are the key skills and qualifications needed to thrive in healthcare claims processing, and why are they important?

To thrive in Healthcare Claims Processing, you need a solid understanding of medical billing, insurance policies, and healthcare regulations, often supported by relevant coursework or certification. Familiarity with claims management software, coding systems like ICD-10 and CPT, and electronic data interchange (EDI) platforms is typically required. Attention to detail, analytical thinking, and strong organizational skills are crucial soft skills for this role. These abilities ensure accurate and timely claims processing, minimizing errors and optimizing reimbursement for healthcare providers.

What is the difference between Healthcare Claims Processing vs Medical Billing Specialist?

AspectHealthcare Claims ProcessingMedical Billing Specialist
Primary RoleReviewing and submitting insurance claims for reimbursementCreating and managing patient invoices and billing records
CredentialsKnowledge of insurance policies, coding, and claims softwareKnowledge of billing procedures, coding, and insurance requirements
Work EnvironmentHealthcare facilities, insurance companies, or billing companiesMedical offices, hospitals, or billing service providers
Industry UsageUsed across healthcare providers and insurance payersPrimarily in healthcare provider settings

While both roles involve coding and insurance knowledge, Healthcare Claims Processing focuses on submitting and managing insurance claims, whereas Medical Billing Specialists handle patient billing and invoicing. Both roles are essential for revenue cycle management in healthcare organizations.

More about Healthcare Claims Processing jobs

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Cities with the most Healthcare Claims Processing job openings:

What states have the most Healthcare Claims Processing jobs?

States with the most job openings for Healthcare Claims Processing jobs include:

What job categories do people searching Healthcare Claims Processing jobs look for?

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Healthcare Claims Processing jobs near you
Infographic showing various Healthcare Claims Processing job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 67% Full Time, 14% Part Time, and 17% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $39,863 per year, or $19.2 per hour.

HealthCare Claims Clerk (On-site)

Shield HealthCare

Valencia, CA • On-site

$19.50/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 16 days ago

Key responsibilities

  • Research and resolve medical supply claims rejections, denials, and underpayments by preparing and submitting corrected claims and appeals.

  • Identify problems in the billing process and recommend claims for write-off when billing requirements are not met.

  • Communicate with third-party payers and internal staff via phone, email, and in person to resolve billing issues and establish positive relationships.

Job description

 
 

Since 1957, Shield Healthcare has provided high-quality healthcare services while focusing on customer satisfaction and employee achievement. We are dedicated to fulfilling the medical supply needs of consumers and the caregiving community while maintaining a 99% overall customer satisfaction rating. Over the years, Shield HealthCare has expanded nationally with current service locations in California, Colorado, Illinois, Ohio, Texas and Washington.


Shield HealthCare is looking for a Healthcare Claims Clerk to research medical supply claims rejections, denials, and underpayments, making the necessary corrections to meet billing guidelines or recommending claims for write-off. The position has a set schedule, Monday through Friday, no nights or weekends. 

This is an on-site position in Valencia, CA.

JOB RESPONSIBILITIES:

  • Reviews the claims billing processes, looking for ways to achieve positive financial outcomes
  • Identify problems and find solutions to claim rejections, denials, and underpayments
  • Inform management of trends in billing issues related to internal processes, clearinghouse claims processing, and third-party requirements
  • Research denials and billing requirements of third-party carriers utilizing EOBs, provider manuals, web portals, and phone contact
  • Adjudicate claims issues by preparing and submitting corrected claims and appeals
  • Recommend claims for write-off when billing requirements are not met
  • Effectively communicate by phone, email, and in-person with third-party payers and internal staff to resolve billing issues and establish positive relationships
  • Accurately update and notate accounts receivable system, collections notepad, and customer accounts
  • Remain updated on company policies and procedures and third-party payer guidelines, bulletins, and billing requirements
  • Ensure appropriate follow-up and timely completion of assignments
  • Completes special projects as assigned, supporting team and organizational objectives and continuous improvement initiatives


QUALIFICATIONS:

  • High school diploma or equivalent
  • 2 years in a medical billing or collections role or similar experience
  • Medical billing and coding certification from accredited program preferred
  • Familiarity with various medical insurance payer guidelines/billing requirements preferred
  • Proficiency in Microsoft 365 (Excel, PowerPoint, Word, SharePoint, Teams)
  • Experience working in Excel
  • Strong written and verbal communication abilities
  • Proven ability to research and solve problems
  • Strong organizational skills, detail oriented, thorough, accurate, with the ability to manage multiple priorities and respond to changing business needs

PAY & BENEFITS:

  •  $19.50/hour
  • Medical, Dental, and Vision (Available first day of employment)
  • 401(k) with Company Match 
  • Sick and Vacation Days 
  • Flexible Spending Account 
  • Life & Disability Insurance 
  • Education Assistance


Career-minded individuals will find our business challenging and our reputation for excellence just one of the rewards we have to offer. To further enhance this tradition of excellence, our employees participate in continuous training and development programs in a variety of disciplines.

 The posted range for this position is $19.50/hour which is the expected starting base salary range for an employee who is new to the role to fully proficient in the role. Many factors go into determining employee pay withing the posted range including education, prior experience, training, current skills, certifications, location/labor market, internal equity, etc.

 

Shield Healthcare, Inc. is an Equal Employment Opportunity Employer and does not discriminate against applicants or employees on the basis of race, color, religion, creed, national origin, ancestry, disability that can be reasonably accommodated without undue hardship, sex, sexual orientation, gender identity, age, citizenship, marital or veteran status, or any other legally protected status.