Ability to analyze medical claim data to identify opportunities for claim edits preferred. * Broad understanding of BCBSM PPO/BCN reimbursement, medical and payment policies is preferred. * Ability ...
Ability to analyze medical claim data to identify opportunities for claim edits preferred. * Broad understanding of BCBSM PPO/BCN reimbursement, medical and payment policies is preferred. * Ability ...
Utilizes provider documentation and queries, coding software tools and Insurance carrier medical ... The appeals process may include collaboration with the Claim Editing Manager, Physician, Specialty ...
Utilizes provider documentation and queries, coding software tools and Insurance carrier medical ... The appeals process may include collaboration with the Claim Editing Manager, Physician, Specialty ...
Ability to analyze medical claim data to identify opportunities for claim edits preferred. * Broad understanding of BCBSM PPO/BCN reimbursement, medical and payment policies is preferred. * Ability ...
Ability to analyze medical claim data to identify opportunities for claim edits preferred. * Broad understanding of BCBSM PPO/BCN reimbursement, medical and payment policies is preferred. * Ability ...
Ability to analyze medical claim data to identify opportunities for claim edits preferred. * Broad understanding of BCBSM PPO/BCN reimbursement, medical and payment policies is preferred. * Ability ...
Ability to analyze medical claim data to identify opportunities for claim edits preferred. * Broad understanding of BCBSM PPO/BCN reimbursement, medical and payment policies is preferred. * Ability ...
Insurance Biller/Professional Billing
Weymouth, MA · On-site
$21.05 - $29.45/hr
Notifies manager of any changes that would affect claim submission Evaluates daily claim file using online claim editing software for submission of 1500 claim forms. * Initiate claim corrections as ...
Insurance Biller/Professional Billing
Weymouth, MA · On-site
$21.05 - $29.45/hr
Notifies manager of any changes that would affect claim submission Evaluates daily claim file using online claim editing software for submission of 1500 claim forms. * Initiate claim corrections as ...
Video Editor REMOTE
Jersey City, NJ · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Quick apply
Video Editor REMOTE
Jersey City, NJ · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Denver, CO · On-site +1
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Denver, CO · On-site +1
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Phoenix, AZ · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Phoenix, AZ · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Tampa, FL · On-site +1
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Tampa, FL · On-site +1
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Phoenix, AZ · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Quick apply
Video Editor REMOTE
Phoenix, AZ · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Austin, TX · On-site +1
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Austin, TX · On-site +1
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Columbus, OH · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Columbus, OH · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Columbus, OH · On-site +1
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Columbus, OH · On-site +1
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Denver, CO · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Denver, CO · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Tampa, FL · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Tampa, FL · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Charlotte, NC · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Quick apply
Video Editor REMOTE
Charlotte, NC · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Philadelphia, PA · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Quick apply
Video Editor REMOTE
Philadelphia, PA · Remote
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Salt Lake City, UT · On-site +1
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Video Editor REMOTE
Salt Lake City, UT · On-site +1
Many companies claim it. We actually mean it. As a leading provider of high-quality supplements ... Health (medical, dental, vision) benefits and 401k benefits offered after 60 days * Paid time off ...
Medical Claim Editor information
See salary details
$19.47 - $22.71
6% of jobs
$22.71 - $25.94
3% of jobs
$25.94 - $29.17
0% of jobs
$29.17 - $32.41
2% of jobs
$35.10 is the 25th percentile. Wages below this are outliers.
$32.41 - $35.64
16% of jobs
$35.64 - $38.88
10% of jobs
The median wage is $40.82 / hr.
$38.88 - $42.11
21% of jobs
$42.11 - $45.35
9% of jobs
$45.35 - $48.58
7% of jobs
$48.76 is the 75th percentile. Wages above this are outliers.
$48.58 - $51.81
10% of jobs
$51.81 - $55.05
16% of jobs
$19
$41
$55
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?
| Aspect | Medical Claim Editor | Medical Billing Specialist |
|---|---|---|
| Credentials | Certification in medical coding or claims processing | Certification in medical billing or coding |
| Work Environment | Insurance companies, healthcare providers, or billing companies | Hospitals, clinics, or healthcare practices |
| Primary Responsibilities | Reviewing and editing insurance claims for accuracy | Submitting and managing patient bills and insurance claims |
| Common Usage | Ensuring claims are correctly processed before submission | Handling 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:
Analyst Senior - Payment Integrity Prospective Editing
Detroit, MI • On-site
Blue Cross Blue Shield of Michigan •
Insurance Services • 5 - 10K employees5,001 - 10,000 employees
Full-time
Posted 13 days ago
Blue Cross Blue Shield of Michigan rating
7.8
Based on 28 frontline employees who took The Breakroom Quiz
196th of 315 rated insurance
Job description
Responsible for leading the development and implementation of programs and strategies by identifying insights that enhance business decision making capability. This includes developing or changing workflows and implementing process improvements to enhance organizational products, programs and service to our customers.
- Identify and analyze operational data and develop insights in support of business objectives.
- Develop and improve work flows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality.
- Identify and/or analyze business problems and develop recommendations for solutions to problems.
- Lead the development and implementation of projects and/or teams in order to produce desired results.
- Document and communicate project concepts, milestones and results.
- Recommend and assist with implementing standard policies and procedures.
- Ensure that corporate compliance is communicated, implemented and monitored on an ongoing basis.
- Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
- Provide support to internal departments and external entities by answering questions, supplying information and training.
- Create and present reports and presentations to display operational data and proposed business changes.
"Qualifications"
- Bachelor's Degree in a related field is preferred.
- Four (4) years of experience in a related field is required.
- Excellent analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.
- Organizational skills and ability to prioritize; must be able to lead multiple activities with varying timelines.
- Excellent verbal, written communication and interpersonal skills.
- Ability to lead and contribute to business unit and/or corporate projects.
- Proficient in Microsoft Office Suites.
Ability to develop and maintain effective working relationships.
Departmental Preferences:
- Ability to analyze medical claim data to identify opportunities for claim edits preferred.
- Broad understanding of BCBSM PPO/BCN reimbursement, medical and payment policies is preferred.
- Ability to apply advanced data analytic techniques and root cause analysis is preferred.
- Intermediate skill using Microsoft applications including Excel, Word and PowerPoint is preferred.
Expert level experience with NASCO claims system preferred.
All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.
What Blue Cross Blue Shield of Michigan employees say
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Benefits
Hours and flexibility
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About Blue Cross Blue Shield of Michigan
Sourced by ZipRecruiter
Industry
Insurance services
Company size
5,001 - 10,000 Employees
Headquarters location
Detroit, MI, US
Year founded
1934