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Medicaid Claims Processing Jobs (NOW HIRING)

Memorial Health

Medicaid Specialist

Springfield, IL · Remote

$18.34 - $28.42/hr

Prioritizes claims based on specified criteria and electronically files the claim, ensuring careful adherence to Medicaid guidelines, timeliness, accuracy, and processing procedures. At prescribed ...

Next Step Systems

Claims Examiner

Tucson, AZ · On-site

... Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Claims Examiner consists of processing claim data and ...

Arcadia Care

Medicaid Specialist

Lincolnwood, IL · On-site

Strong understanding of Medicaid eligibility, authorization, and claims processes * Ability to analyze account discrepancies and resolve complex billing issues * Excellent communication skills with ...

Next Step Systems

Medical Claims Examiner

Tucson, AZ · On-site

... Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Medical Claims Examiner consists of processing claim data and ...

TechData Service Company LLC

Be Seen First

Medicaid Claims Analyst (LC9869)

Parsippany, NJ · On-site

$60 - $70/hr

Must have Medicaid Rebate experience with processing Model N. Duration of Contingent Assignment ... The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate processing which includes ...

Arcadia Care

Medicaid Specialist

Lincolnwood, IL · On-site

$75K/yr

Strong understanding of Medicaid eligibility, authorization, and claims processes * Ability to analyze account discrepancies and resolve complex billing issues * Excellent communication skills with ...

Next Step Systems

Medical Claims Coder

Tucson, AZ · On-site

... Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Medical Claims Coder consists of processing claim data and ...

1 Legacy, Inc

Manager I Claims

Miami, FL

Assure timely and accurate processing of Medicare claims and encounters, and respond to provider ... Minimum of 5 years of Medicare/Medicaid claims experience that demonstrates progressive growth ...

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Medicaid Claims Processing information

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How much do medicaid claims processing jobs pay per hour?

As of Jun 11, 2026, the average hourly pay for medicaid 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 a Medicaid Claims Processing job?

A Medicaid Claims Processing job involves reviewing, verifying, and processing healthcare claims submitted by providers seeking reimbursement for services rendered to Medicaid beneficiaries. Workers in this role ensure claims comply with state and federal regulations, identify errors or discrepancies, and communicate with healthcare providers to resolve issues. They may also use specialized software to input and track claims, process denials or appeals, and ensure timely and accurate payments. Strong attention to detail, knowledge of Medicaid policies, and proficiency with healthcare billing codes are essential for success in this role.

What are some typical challenges faced in Medicaid Claims Processing, and how can I prepare for them?

One of the main challenges in Medicaid Claims Processing is staying up-to-date with frequently changing policies, billing codes, and compliance requirements, which can vary by state and program. Professionals in this role must pay close attention to detail to avoid errors and denials, often working with tight deadlines and large volumes of claims. To prepare, it's helpful to become familiar with Medicaid guidelines, maintain strong organizational habits, and proactively seek out updates in regulations or coding standards. Collaborating with other team members, such as care coordinators and billing specialists, is essential to ensure claims are accurate and properly documented. Ongoing learning and adaptability are key for long-term success in this dynamic environment.

What are the key skills and qualifications needed to thrive in the Medicaid Claims Processing position, and why are they important?

Success in Medicaid Claims Processing requires excellent attention to detail, a thorough understanding of healthcare billing procedures, and familiarity with Medicaid regulations and insurance guidelines. Proficiency in medical billing software, claims management systems, and sometimes industry certifications such as Certified Professional Coder (CPC) is beneficial. Strong organizational skills, problem-solving abilities, and effective written and verbal communication help individuals excel in this role. These skills and qualifications are crucial for ensuring accurate, timely claims processing and compliance with ever-evolving Medicaid requirements.

More about Medicaid Claims Processing jobs
What cities are hiring for Medicaid Claims Processing jobs? Cities with the most Medicaid Claims Processing job openings:
What are the most commonly searched types of Medicaid Claims Processing jobs? The most popular types of Medicaid Claims Processing jobs are:
What states have the most Medicaid Claims Processing jobs? States with the most job openings for Medicaid Claims Processing jobs include:
What job categories do people searching Medicaid Claims Processing jobs look for? The top searched job categories for Medicaid Claims Processing jobs are:
Medicaid Claims Processing jobs near you
Infographic showing various Medicaid Claims Processing job openings in the United States as of June 2026, with employment types broken down into 93% Full Time, 5% Part Time, and 2% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $39,863 per year, or $19.2 per hour.
Medicaid Specialist

Medicaid Specialist

Memorial Health

Springfield, IL • Remote

$18.34 - $28.42/hr

Full-time

Medical, Vision

Posted 24 days ago

Memorial Health rating

6.8

Company rating: 6.8 out of 10

Based on 170 frontline employees who took The Breakroom Quiz

486th of 870 rated healthcare providers

Job description

USD $18.34/Hr.
USD $28.42/Hr.

Position Summary:

Analyzes, investigates, and resolves claims/billing information and/or errors associated with inpatient and outpatient Medicaid claims. Ensures compliance with Medicaid guidelines and MMC organizational policies.  Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values.

To review Memorial's Benefits click here: Benefits - Memorial HR


Education:

Education equivalent to graduation from high school or GED is required.

Experience:

Two or more years of insurance and/or health care billing experience is required. Previous experience with Medicaid billing and software (IDPA payment system, SMS, and NEBO) is highly preferred.

Other Knowledge/Skills/Abilities:

  • Basic working knowledge of personal computers and their associate user software is required. Experience with Microsoft Office products Word and Excel is preferred.
  • Ability to multi-task while working on multiple responsibilities simultaneously.
  • Demonstrated ability to work successfully with internal customers and external contacts is required.
  • Possesses a highly-developed critical thinking and problem solving-ability to work through complex situations.
  • Demonstrates excellent oral and written communication, keyboarding, basic math, and problem solving skills.
  • Familiarity with medical terminology, medical procedural (CPT) and diagnosis (ICD-9 CM) coding, and hospital billing claim form UB-04 is highly preferred.

Principal Duties & Responsibilities:

  1. Utilizes electronic software to determine Medicaid insurance eligibility and coverage for inpatient and/or outpatient Medicaid claims.
  1. Receives and examines daily listings for assigned billing claims and determines which require further analysis and action.
  1. Investigates assigned billing claims with incomplete/incorrect information and resolves problems or errors to ensure complete and Medicaid-compliant information accompanies the claim.
  1. Prioritizes claims based on specified criteria and electronically files the claim, ensuring careful adherence to Medicaid guidelines, timeliness, accuracy, and processing procedures. At prescribed intervals, follows up for review to ensure smooth processing and timely delivery of monetary reimbursements.
  2. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values:
  • SAFETY: Prevent Harm - I put safety first in everything I do.  I take action to ensure the safety of others.
  • COURTESY: Serve Others - I treat others with dignity and respect.  I project a professional image and positive attitude.
  • QUALITY: Improve Outcomes - I continually advance my knowledge, skills and performance.  I work with others to achieve superior results.
  • EFFICIENCY: Reduce Waste - I use time and resources wisely.  I prevent defects and delays.
  1. Follows up and investigates unpaid items and other issues associated with unpaid claims. Contacts patients, guarantors, or other sources of third party payment and secures arrangements for prompt payment.
  1. Receives and researches Medicaid claim denials, and as necessary, prepares the necessary paperwork to appeal the denial.
  1. Reviews correspondence relating to Medicaid payments and claims; conducts the necessary research to provide supplementary background information regarding the inquiry.
  1. Researches and resolves complex issues associated with Medicaid accounts. As applicable, identifies, documents, and reports problematic trends to management.
  1. Analyzes reports containing rejected account information and performs the necessary research to resolve the reason(s) for the rejection and secures any other required information.
  1. Provides input regarding system edits designed to identify and ensure consistent and compliant data necessary for processing Medicaid claims.
  1. Responds to requests from internal departments regarding the proper coding, billing, and processing of Medicaid claims.
  1. Communicates and resolves issues with a variety of internal and external sources to resolves issues involving Medicaid claims. This may include internal departments, patients (or other responsible parties), third-party payors, social service agencies, Medicare/Medicaid staff, other insurance carriers, service providers, and collection agencies.
  1. Initiates corrections to charges and contractuals / allowances within scope of expertise and authority granted.
  1. Identifies and calculates write-off amounts and secures the necessary approvals from management for processing.
  1. Documents online systems and electronic files to ensure accurate data is noted regarding the status of claims and payments.
  1. Ensures compliance to Medicaid policy guidelines and processes at each work step to facilitate accurate and timely reimbursements to the organization.
  1. As directed and defined by management, orients and cross-trains on other unit duties which are outside of regularly assigned area of responsibility. May serve as a back-up for other areas within the unit or department, especially during times of special needs or staff absences.
  2. Performs other related work as required or requested.

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