ZipRecruiter

Log In

1

Medical Claim Jobs (NOW HIRING)

The Whiteside Agency

Chief Medical Officer

Braintree, MA · On-site

$262K - $404K/yr

Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how ... developments in the broader medical environment impact Property & Casualty product lines. This role ...

The Whiteside Agency

Chief Medical Officer

Richardson, TX · On-site

$262K - $404K/yr

Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how ... developments in the broader medical environment impact Property & Casualty product lines. This role ...

The Whiteside Agency

Chief Medical Officer

Orlando, FL · On-site

$262K - $404K/yr

Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how ... developments in the broader medical environment impact Property & Casualty product lines. This role ...

1199SEIU Funds

Processor IV

Hicksville, NY · On-site

... medical claim image and other reference materials as appropriate Apply contractual benefits, medical policy, and operational procedures to finalize claim Handle adjustments and reversals of ...

The Whiteside Agency

Chief Medical Officer

Chicago, IL

$262K - $404K/yr

Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how ... developments in the broader medical environment impact Property & Casualty product lines. This role ...

The Whiteside Agency

Chief Medical Officer

Alpharetta, GA · On-site

$262K - $404K/yr

Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how ... developments in the broader medical environment impact Property & Casualty product lines. This role ...

The Whiteside Agency

Chief Medical Officer

Hartford, CT · On-site

$262K - $404K/yr

Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how ... developments in the broader medical environment impact Property & Casualty product lines. This role ...

The Whiteside Agency

Chief Medical Officer

Tampa, FL

$262K - $404K/yr

Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how ... developments in the broader medical environment impact Property & Casualty product lines. This role ...

TTF

Be Seen First

Medical Billing and Revenue Cycle Payment Poster

Newport Beach, CA · On-site

$21 - $24/hr

Qualified candidates should have previous experience in medical claim billing, insurance follow-up, and have knowledge of Medi-Cal guidelines. In addition, qualified candidates must have a stable ...

next page

Showing results 1-20

All JobsMedical Claim Jobs

Medical Claim information

See salary details

$5

$16

$18

How much do medical claim jobs pay per hour?

As of Jun 11, 2026, the average hourly pay for medical claim in the United States is $16.83, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $18.27 per hour, depending on experience, location, and employer.
What cities are hiring for Medical Claim jobs? Cities with the most Medical Claim job openings:
What states have the most Medical Claim jobs? States with the most job openings for Medical Claim jobs include:
Medical Compliance Auditor

Medical Compliance Auditor

Texas Children's Hospital

Bellaire, TX • On-site

Full-time

Posted 20 days ago

Texas Children's Hospital rating

8.4

Company rating: 8.4 out of 10

Based on 171 frontline employees who took The Breakroom Quiz

63rd of 998 rated hospitals

Job description

Job Description
We are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria.
Think you've got what it takes?
Job Duties & Responsibilities
• Assess the treatment plan, clinical information, and medical necessity of all requested services
• Utilizes established criteria to appropriately review billed services within established timeframe required.
• Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate.
• Refers case failing medical necessity criteria to the Special Investigations Unit (SIU) Director and SIU Workgroup for review and a recommendation for action.
• Telephonic follow-up with the provider's office to request additional information as needed.
• Completes timely entry of information into electronic file including a chart with detailed findings of the review and a report summarizing the results of the audit.
• Evaluate benefit coverage and regulatory guidelines pertinent to decision making for each investigation.
• Perform Clinical and Coding Review on Medical Claim Appeals.
• Assess and process all education and recoupment letters after Special Investigative Committee review decision.
• Facilitates provider communication and education.
• Liaisons with internal staff members.
• Perform Clinical Review and make recommendation on Audit Pass/Fail.
• Ongoing assessment for quality indicators and concerns.
Skills & Requirements
• Required Associate's Degree in Nursing or
• Technical Diploma in Vocation Nursing
• Preferred Bachelor's Degree in Nursing
• Required LVN - Lic- Licensed Vocational Nurses Texas Board of Nursing or Nursing Licensure Compact
• Preferred CPC-Cert-Cert Professional Coder Americal Academy of Professional Coders
• Preferred RN-Lic-Registered Nurses Texas Board of Nursing or Nursing Licensure Compact
• Required 3 years of LVN experience
• 4 years of Medical Auditing experience.
About Us
Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.
Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

What Texas Children's Hospital employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply