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Healthcare Claims Representative Jobs (NOW HIRING)

System One

Healthcare EDI Claims Analyst

Columbia, MD · On-site

$52.96/hr

Healthcare EDI Claims Analyst Location: Hybrid - Columbia/Baltimore, MD (2-3 days onsite per month) Duration: 12-Month Contract-to-Hire Pay Rate: $52.96/hour W2 (No PTO) About the Role We are seeking ...

AmTrust Financial

Claims Representative

Dallas, TX · On-site

... Representative is responsible for prompt efficient review and disposition of insurance claims ... Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible ...

Mercer France

Claims Representative

Houston, TX · On-site

Claim Representative Our not-so-secret sauce. Award winning, inclusive, Top Workplace culture doesn ... Marsh McLennan Agency (MMA) provides business insurance, employee health & benefits, retirement ...

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Healthcare Claims Representative information

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How much do healthcare claims representative jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for healthcare claims representative in the United States is $24.12, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $27.40 per hour, depending on experience, location, and employer.

What does a healthcare claims representative do?

A Healthcare Claims Representative is responsible for processing and reviewing medical insurance claims submitted by healthcare providers or patients. They verify the accuracy of information, ensure that claims comply with insurance policies, and determine the coverage and payment amounts. Their work involves communicating with healthcare providers, patients, and insurance companies to resolve any discrepancies or issues. By efficiently handling claims, they help ensure timely reimbursement and maintain the integrity of the claims process.

What are the key skills and qualifications needed to thrive as a healthcare claims representative, and why are they important?

To thrive as a Healthcare Claims Representative, you need a solid understanding of medical terminology, insurance processes, and claims adjudication, often supported by a high school diploma or associate degree. Familiarity with claims management software, EHR systems, and coding tools like ICD-10 and CPT is typically required. Strong attention to detail, problem-solving abilities, and effective communication skills help you resolve discrepancies and work with providers and patients. Mastering these skills ensures accurate claims processing, minimizes errors, and supports efficient reimbursement and client satisfaction.

What are common challenges faced by healthcare claims representatives and how can they be managed?

Healthcare Claims Representatives often encounter challenges such as navigating complex insurance policies, resolving claim discrepancies, and ensuring compliance with healthcare regulations. Managing these challenges requires strong attention to detail, effective communication skills, and the ability to stay organized under tight deadlines. Building a collaborative relationship with healthcare providers and insurers, as well as staying updated on policy changes, can help representatives resolve issues efficiently and maintain a high level of accuracy in their work.

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

AspectHealthcare Claims RepresentativeMedical Billing Specialist
CredentialsHigh school diploma; certifications like Certified Professional Coder (CPC) or claims-specific trainingHigh school diploma; certifications such as CPC or Certified Medical Billing Specialist (CMBS)
Work EnvironmentInsurance companies, healthcare providers, billing officesMedical offices, hospitals, billing companies
Job FocusReviewing, submitting, and following up on insurance claimsPreparing and submitting medical bills, managing accounts receivable

While both roles involve handling medical billing and insurance processes, Healthcare Claims Representatives primarily focus on managing insurance claims, ensuring proper submission and follow-up. Medical Billing Specialists handle the overall billing process, including preparing bills and managing payments. Both roles require similar certifications and often work in healthcare or insurance settings, but their core responsibilities differ slightly.

What cities are hiring for Healthcare Claims Representative jobs?

Cities with the most Healthcare Claims Representative job openings:

What states have the most Healthcare Claims Representative jobs?

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

What are popular job titles related to Healthcare Claims Representative jobs?

For Healthcare Claims Representative jobs, the most frequently searched job titles are:

Infographic showing various Healthcare Claims Representative 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 $50,180 per year, or $24.1 per hour.

Senior Claims Representative

Carmel, IN • On-site

Brown & Brown, Inc.
Law Firms • 11 - 50 employees
Learn more about Brown & Brown, Inc.external

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago

Job description

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.
Brown & Brown is seeking a Senior Claims Representative to join our growing team in Carmel, IN!
The Senior Claims Representative manages high priority accounts and catastrophic claims.
How You Will Contribute:
  • Maintain a claim inventory as deemed appropriate by management

  • Verify, research evaluate and make recommendations on appropriate coverage on each claim, using discretionary judgment

  • Make timely contact with members, injured workers, agents, providers, attorneys, etc.

  • Investigate claim with phone interviews/emails and obtain appropriate documentation

  • Evaluate exposure and adjust reserves as required

  • Conclude claim processing in accordance with company standards

  • Meet with members, agents, injured workers, attorneys, etc. as deemed necessary

  • Provide training and act as a mentor for members and other claims personnel

  • Travel to annual workers compensation conference and/or attend educational seminars

  • Other job-related projects or assignments as delegated

  • The Sr. Claims Representative will maintain and uphold a high standard for customer service.

Licenses and Certifications:
  • Insurance and/or Industry certification or designation

Skills & Experience to Be Successful:
  • Associate's or Bachelor's degree in business, financial related discipline,

  • or Human Resources (preferred)

  • Proficient with Microsoft, Windows, Excel, IVOS, etc.

  • Exceptional telephone demeanor

  • Ability to maintain a high level of confidentiality

  • 3 - 5 years' experience in similar position

Teammate Benefits & Total Well-Being
We go beyond standard benefits, focusing on the total well-being of our teammates, including:
  • Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
  • Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
  • Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services
  • Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.

Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.
The Power To Be Yourself
As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, "The Power to Be Yourself".

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