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Healthcare Claims Processing Jobs (NOW HIRING)

ClinDCast LLC

Healthcare System Analyst

Mason, OH · On-site

Knowledge of healthcare claims processing and member/provider workflows. * Experience working with Java-based enterprise applications. * Experience supporting React-based web platforms/applications.

Trinityhealth

$18.50 - $24.66/hr

Claims Processing Tech - Eddy Senior Care- FT Days Location: 433 River St, Troy, NY Narrative: Eddy ... High School Diploma required along * 2-3 years of experience in a billing position or a health care ...

Prosper Services LLC

Claims Analyst

California, MO · On-site

$60 - $80/hr

Strong knowledge of healthcare claims processing systems; experience with QuickCap is preferred. * Knowledge of electronic data interchange workflows and coordination of benefits. * Understanding of ...

Guidewell

Claims Examiner I

Irving, TX · On-site

As a Claim Examiner, you will handle processing and adjudication for healthcare claims. This will include claims research where applicable and a range of claim complexity. What Will You Be Doing:

Consociate Health

Claims Auditor

IL · On-site +1

$23 - $24/hr

Experience in Healthcare Claims Processing preferred. * Auditing experience a plus. PHYSICAL AND MENTAL ABILITIES: * Ability to perform sedentary work for extended periods of time. * Ability to ...

System One

Sr. Pega Engineer

Farmers Branch, TX · On-site

Apply strong understanding of healthcare claims processing throughout the migration. * Work with business SMEs to understand and reengineer functionalities such as claims intake, validation ...

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Healthcare Claims Processing information

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$12

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$26

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.

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What states have the most Healthcare Claims Processing jobs?

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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 System Analyst

ClinDCast LLC

Mason, OH • On-site

Full-time

Re-posted 26 days ago

Job description

Job Summary
We are seeking an experienced Healthcare System Analyst with strong expertise in Payer Systems, Facets, Java-based applications, and React platforms. The ideal candidate will work closely with business stakeholders, developers, QA teams, and healthcare operations teams to analyze requirements, support system enhancements, and deliver scalable healthcare payer solutions.
The candidate should possess strong knowledge of healthcare claims, enrollment, provider, and member workflows along with hands-on experience in Facets configuration/support and modern web application platforms.
Responsibilities
  •  Analyze business and system requirements for healthcare payer applications. 
  •  Work with stakeholders to gather, document, and validate functional and technical requirements. 
  •  Support and maintain Facets modules including Claims, Membership, Billing, Provider, and Authorization workflows. 
  •  Collaborate with Java and React development teams for application enhancements and integrations. 
  •  Create functional specifications, process flows, use cases, and system documentation. 
  •  Coordinate with QA teams during test planning, defect resolution, and UAT activities. 
  •  Troubleshoot production issues and provide root cause analysis. 
  •  Support system integrations using APIs, batch processes, and healthcare data exchange formats. 
  •  Participate in Agile/Scrum ceremonies including sprint planning, stand-ups, and retrospectives. 
  •  Ensure compliance with healthcare regulations and payer business standards. 
  •  Assist in deployment activities and post-production support. 
Required Skills
  •  5+ years of experience as a Healthcare System Analyst or Business Systems Analyst. 
  •  Strong experience with Healthcare Payer systems. 
  •  Hands-on experience with Facets platform. 
  •  Knowledge of healthcare claims processing and member/provider workflows. 
  •  Experience working with Java-based enterprise applications. 
  •  Experience supporting React-based web platforms/applications. 
  •  Strong SQL and data analysis skills. 
  •  Experience with REST APIs and system integrations. 
  •  Knowledge of SDLC, Agile, and Scrum methodologies. 
  •  Excellent communication and documentation skills. 
Preferred Skills
  •  Experience with Medicare/Medicaid lines of business. 
  •  Knowledge of HL7, EDI X12, or FHIR integrations. 
  •  Experience with Jira, Confluence, and testing tools. 
  •  Exposure to cloud platforms such as AWS or Azure.

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About ClinDCast

Sourced by ZipRecruiter

ClinDCast is at the forefront of shaping the future of healthcare by partnering with globally recognized healthcare organizations and offering them innovative solutions and expert guidance. Our suite of services is designed to cater to a broad range of needs of healthcare organizations, including healthcare IT innovation, electronic health record (EHR) implementation & optimizations, data conversion, regulatory and quality reporting, enterprise data analytics, FHIR interoperability strategy, payer-to-payer data exchange, and application programming interface (API) strategy. With 15+ Years Of Healthcare IT Industry Experience, ClinDCast Is A Trusted Partner For Payers, Providers, And Lifesciences Organizations, Enabling Them To Deliver Exceptional Product And Solutions For Their Customers.

Industry

Health care and social assistance

Company size

11 - 50 Employees

Headquarters location

Wesley Chapel, FL, US

Social media

Twitter

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