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Medical Claim Editor Jobs (NOW HIRING)

OKCIC

Epic PB Claims Remittance Analyst

Oklahoma City, OK · On-site

$80 - $100/hr

OKCIC services include not only basic medical care but also dental, optometry, behavioral health ... Set up system processing tools for payment rejections, remittance errors, and claim editing work ...

Jobtailor

Insurance Billing Professional

Holland, MO · On-site

$60 - $80/hr

Claim Editing Tools * Payer Portals * Data Analysis * Medical Necessity Validation * Authorization Verification * Denial Trend Identification * Patient Balance Billing * Documentation Accuracy

New

Machinify

Senior Data Analyst

$140K - $170K/yr

Deep knowledge of medical claim types (professional and institutional), coding systems (ICD-10-CM ... Hands-on payment integrity experience: overpayment detection, COB, billing edits, or claim editing ...

Machinify

Senior Data Analyst

$88K - $111K/yr

Deep knowledge of medical claim types (professional and institutional), coding systems (ICD-10-CM ... Hands-on payment integrity experience: overpayment detection, COB, billing edits, or claim editing ...

Moda Health

RN Hospital Claims Auditor

Portland, OR · On-site +1

$78K - $98K/yr

Perform pre and post pay medical claim reviews utilizing itemized hospital bills and other ... Provide advice and recommendations to Clinical Policy unit on proper system coding and editing ...

Page Mechanical Group, Inc.

$80 - $100/hr

Perform pre and post pay medical claim reviews utilizing itemized hospital bills and other ... Provide advice and recommendations to Clinical Policy unit on proper system coding and editing ...

New

Keck Medicine of USC

$22.25 - $29.25/hr

Assigns CPT-4 and ICD-9CM codes to medical services and diagnoses. Enters charge data into billing ... Review and correct minor claim errors identified in front-end claim editor. Makes charge ...

University of Southern California

$22.25 - $29.25/hr

Assigns CPT-4 and ICD-9CM codes to medical services and diagnoses. Enters charge data into billing ... Review and correct minor claim errors identified in front-end claim editor. Makes charge ...

USC Gould School of Law

$22.25 - $29.25/hr

Assigns CPT-4 and ICD-9CM codes to medical services and diagnoses. Enters charge data into billing ... Review and correct minor claim errors identified in front-end claim editor. Makes charge ...

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Medical Claim Editor information

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$41

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How much do medical claim editor jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for medical claim editor in the United States is $41.22, according to ZipRecruiter salary data. Most workers in this role earn between $34.62 and $50.24 per hour, depending on experience, location, and employer.

What is a medical claim editor?

A Medical Claim Editor is a professional responsible for reviewing, correcting, and processing medical claims before they are submitted to insurance companies. They ensure that claims are accurate, complete, and compliant with current healthcare regulations and coding standards. By catching errors and inconsistencies, Medical Claim Editors help healthcare providers receive timely and proper reimbursement for services rendered. Their work helps reduce claim denials and delays, ultimately improving the efficiency of healthcare billing processes.

What are the key skills and qualifications needed to thrive as a medical claim editor?

To thrive as a Medical Claim Editor, you need a solid understanding of medical terminology, coding systems (such as ICD-10 and CPT), and healthcare billing processes, often supported by a background in health information management or a related certification. Familiarity with medical billing software, claim management systems, and electronic health record (EHR) platforms is essential. Attention to detail, analytical thinking, and strong communication skills help you accurately review, edit, and resolve claim discrepancies. These skills ensure efficient claims processing, minimize errors, and contribute to timely reimbursement for healthcare providers.

What types of challenges might a medical claim editor face when reviewing and editing claims, and how can these be managed effectively?

Medical Claim Editors often encounter challenges such as incomplete patient information, discrepancies in coding, or missing documentation. Additionally, keeping up with frequent changes in healthcare regulations and payer requirements can be demanding. To manage these challenges, it's important to maintain strong attention to detail, stay updated on the latest coding standards, and communicate regularly with billing teams and healthcare providers. Utilizing up-to-date claim editing software and participating in ongoing training can also help ensure accuracy and compliance.

What is the difference between Medical Claim Editor vs Medical Billing Specialist?

AspectMedical Claim EditorMedical Billing Specialist
CredentialsCertification in medical coding or claims processingCertification in medical billing or coding
Work EnvironmentInsurance companies, healthcare providers, or billing companiesHospitals, clinics, or healthcare practices
Primary ResponsibilitiesReviewing and editing insurance claims for accuracySubmitting and managing patient bills and insurance claims
Common UsageEnsuring claims are correctly processed before submissionHandling overall billing process and patient invoicing

While both roles involve working with insurance claims, a Medical Claim Editor primarily reviews and edits claims for accuracy before submission, ensuring compliance with insurance requirements. A Medical Billing Specialist manages the entire billing process, including submitting claims, following up on payments, and managing patient invoices. Both roles require similar certifications and work in healthcare settings, but their focus and daily tasks differ.

What are popular job titles related to Medical Claim Editor jobs?

For Medical Claim Editor jobs, the most frequently searched job titles are:

Infographic showing various Medical Claim Editor job openings in the United States as of September 2026, with employment types broken down into 100% Full Time. Highlights an 83% In-person, and 17% Remote job distribution, with an average salary of $85,736 per year, or $41.2 per hour.

Configuration Analyst

Tampa, FL • On-site

Avalon Administrative Services LLC
See more jobs at Avalon Administrative Services LLCexternal

Full-time

Re-posted 24 days ago

Job description

About Avalon Healthcare Solutions:

Avalon Healthcare Solutions is the nation’s leader in diagnostic intelligence, uniquely focused on transforming the role of diagnostic testing across the healthcare ecosystem. Our proprietary Diagnostic Insights Platform delivers evidence-based policies, curated lab networks, and real-time analytics that simplify complex diagnostics, accelerate innovation adoption, and optimize diagnostic investments.

Supporting over 30 health plans and 100 million members nationwide, Avalon partners with payers and providers to ensure diagnostic testing is performed appropriately, efficiently, and at the right time. Our flexible solutions span routine and genetic testing management, automated adherence, and end-to-end diagnostics support—driving measurable value, reduced waste, and improved clinical outcomes.

With unmatched scientific rigor, deep clinical expertise, and a performance-based model, Avalon is redefining how diagnostics power personalized care and healthcare value.
 Learn more at www.avalonhcs.com.

You will be part of a team that shapes a new market and business. Most importantly, you will help Avalon to achieve its mission and improve clinical outcomes and health care affordability for the people we serve.

For more information about Avalon, please visit www.avalonhcs.com.

Avalon Healthcare Solutions is an Equal Opportunity Employer - Vet/Disability. 

This position description is subject to change at any time. As determined by the company based upon business needs, an employee in this position may be required to perform duties and take responsibility for work other than as described in this document.

About the Configuration Analyst Position:

Reporting to the Manager, Configuration, the Configuration Analyst is responsible for updating managed care claims processing, maintenance and support of interfaces and third-party applications, process flow updates and enhancements.

This position is eligible for remote work, but quarterly travel will be required to Avalon's corporate office located in Tampa, Florida.

Configuration Analyst – Essential Functions and Responsibilities:

  • Perform analyses of Avalon laboratory benefits management configuration in order to determine and create use cases for regression testing. 
  • Ability to take requirements from medical policy translation documents and successfully incorporate these as rules in the Avalon laboratory benefits management configuration file.
  • Run regression testing prior to Production releases for Avalon Claim Editor to ensure optimal functionality of the Claim Editor.
  • Development and maintenance of ReadyAPI! test suite for regression testing management. 
  • Validate and/or provide input to LBM global rules process flows.

Configuration Analyst – Minimum Qualifications:

  • 3+ years of relevant work experience
  • Bachelor’s degree in Business or similar field or equivalent work experience
  • At least 3 years of experience developing and managing business requirements throughout a project lifecycle.
  • Experience in or knowledge of the health care business and customer service.
  • Intermediate knowledge of Microsoft Excel and Access.
  • Experience with use case testing.
  • 1 - 2 years’ experience in reporting, with a preference for intermediate knowledge of SQL 
  • Knowledge of one or more of the following areas of health plan operations - configuration, utilization, claims processing, and/or reimbursement.
  • Proven analytical and project management skills, including a thorough understanding of how to interpret customer business needs and translate them into application and operational requirements.
  • Facilitation skills that include workgroup leadership, problem resolution across multiple groups, etc.
  • Willingness to work in various capacities and to learn new skill sets.

Apply