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Hospital Claims Jobs (NOW HIRING)

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY · On-site

$18.75 - $23.75/hr

Review hospital claims and determine action needed to resolve pended claims * Process and evaluate hospital claims manually or through claims work flow * Validate information entered in hospital ...

1199SEIU Funds

Manager, Hospital Claims

Manhattan, NY · On-site

Responsibilities Responsible for the day-to-day operations of Hospital Claims Department in the Processor and Clerical Unit at the 1199 SEIU National Benefit Funds Provide direction and support to ...

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY

$18.75 - $23.75/hr

Review hospital claims and determine action needed to resolve pended claims * Process and evaluate hospital claims manually or through claims work flow * Validate information entered in hospital ...

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY

$18.75 - $23.75/hr

Review hospital claims and determine action needed to resolve pended claims * Process and evaluate hospital claims manually or through claims work flow * Validate information entered in hospital ...

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY · On-site

$18.75 - $23.75/hr

Job Title Responsibilities Review hospital claims and determine action needed to resolve pended claims Process and evaluate hospital claims manually or through claims work flow Validate information ...

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY · On-site

$18.75 - $23.75/hr

Review hospital claims and determine action needed to resolve pended claims * Process and evaluate hospital claims manually or through claims work flow * Validate information entered in hospital ...

Moda Health

RN Hospital Claims Auditor

Portland, OR · On-site +1

$78K - $98K/yr

Position Summary Provides clinical and technical analysis for interpretation of appropriate procedural and diagnostic coding and payment of hospital inpatient claims and related inputs. Determines ...

1199seiu

Quality Control Reviewer III

Manhattan, NY · On-site

$18.75 - $23.75/hr

Cross train Processors and Quality Control Reviewers in the Hospital Claims Department * Create advances from providers based on the findings of the Fraud & Abuse Department * Review complex claim ...

1199SEIU Funds

Quality Control Reviewer III

Manhattan, NY · On-site

$18.75 - $23.75/hr

Responsibilities Cross train Processors and Quality Control Reviewers in the Hospital Claims Department Create advances from providers based on the findings of the Fraud & Abuse Department Review ...

1199SEIU Funds

Quality Control Reviewer III

Manhattan, NY

$18.75 - $23.75/hr

Responsibilities Cross train Processors and Quality Control Reviewers in the Hospital Claims Department Create advances from providers based on the findings of the Fraud & Abuse Department Review ...

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Hospital Claims information

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$30.5K

$64.6K

$90K

How much do hospital claims jobs pay per year?

As of Sep 12, 2026, the average yearly pay for hospital claims in the United States is $64,609.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,000.00 and $75,500.00 per year, depending on experience, location, and employer.

What are hospital claims?

Hospital claims are formal requests for payment that hospitals submit to insurance companies or government payers for services provided to patients. These claims include detailed information about the treatments, procedures, and care given, as well as the associated costs. Proper processing of hospital claims ensures that hospitals receive reimbursement for their services and patients are billed accurately. The process involves coding, billing, and compliance checks to ensure the claims meet payer requirements.

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

To thrive in Hospital Claims, you need a solid understanding of medical billing processes, insurance policies, and healthcare regulations, often supported by a degree in health administration or related certifications such as Certified Professional Biller (CPB). Familiarity with claims management software, electronic health records (EHRs), and coding systems like ICD-10 and CPT is essential. Strong attention to detail, problem-solving abilities, and effective communication skills help professionals resolve claim discrepancies and liaise with insurance providers. These skills ensure accurate claim processing, minimize denials, and support financial stability for healthcare organizations.

What are some common challenges hospital claims specialists face when processing insurance claims?

Hospital claims specialists often encounter challenges such as navigating complex insurance policies, dealing with frequent changes in billing codes and regulations, and resolving claim denials or discrepancies. They must stay up to date with payer requirements and ensure accurate documentation to minimize claim rejections. Effective communication with both healthcare providers and insurance representatives is essential to resolve issues promptly and maintain efficient claim processing.

What is the difference between Hospital Claims vs Medical Billing Specialist?

AspectHospital ClaimsMedical Billing Specialist
CredentialsKnowledge of insurance policies, coding, and claims processingCertification in medical billing/coding often preferred
Work EnvironmentHospitals, healthcare facilities, insurance companiesMedical offices, billing companies, healthcare providers
Job ResponsibilitiesSubmitting and managing hospital insurance claims, ensuring reimbursementPreparing and submitting medical bills, verifying insurance coverage

Hospital Claims professionals focus on processing insurance claims specifically for hospital services, handling complex billing and reimbursement issues. Medical Billing Specialists handle a broader range of medical billing tasks across various healthcare settings. While their roles overlap in insurance claim submission, Hospital Claims roles are more specialized in hospital environments and claims processing.

More about Hospital Claims jobs

What cities are hiring for Hospital Claims jobs?

Cities with the most Hospital Claims job openings:

What states have the most Hospital Claims jobs?

States with the most job openings for Hospital Claims jobs include:

What are popular job titles for Hospital Claims?

Popular job titles for Hospital Claims:

Hospital Claims jobs near you
Infographic showing various Hospital Claims job openings in the United States as of August 2026, with employment types broken down into 1% Locum Tenens, 3% As Needed, 69% Full Time, 18% Part Time, and 9% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $64,609 per year, or $31.1 per hour.

Hospital Claims Processor V

Manhattan, NY • On-site

1199SEIU Funds
Insurance Services • 501 - 1,000 employees
Learn more about 1199SEIU Fundsexternal

$18.75 - $23.75/hr

Full-time

Medical

Re-posted 14 days ago

Job description

Responsibilities

  • Review hospital claims and determine action needed to resolve pended claims
  • Process and evaluate hospital claims manually or through claims work flow
  • Validate information entered in hospital claims module (QNXT); determine the process or work flow needed to resolve discrepancies
  • Finalize hospital claims by applying knowledge of eligibility, benefits, pre-authorization rules, contractual policy and operational procedures
  • Review, finalize and respond to call tracking tickets in a timely manner to provider inquires
  • Perform additional duties and special projects as assigned by management


Qualifications

  • High School Diploma or GED required, some College or Degree preferred
  • Minimum two (2) years experience entering and updating hospital or medical claims in a health insurance or benefits environment required
  • Basic keyboarding skills required
  • Strong knowledge of hospital claims, eligibility, benefits, and reauthorization rules; knowledge of health claims system (QNXT)
  • Good knowledge of International Classification of Diseases (ICD-9, ICD-10) and Current Procedural Terminology (CPT) codes
  • Demonstrated organizational, perform multiple priorities, and analytical skills with the ability to follow through on assignments
  • Able to work well independently and in a team environment
  • Ability to meet strict deadlines, work well under pressure and in a fast-paced environment
  • Must meet performance standards including attendance and punctuality
Employment Type: Full time

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