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Medical Claims Executive Jobs (NOW HIRING)

The Doctors Company

$60K - $79K/yr

... owned medical malpractice insurer, The Doctors Company has always been guided by our Mission: To ... The Executive Assistant must understand business priorities and can anticipate management needs.

MSO, INC. OF SOUTHERN CALIFORNIA

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CLAIMS MANAGER

Costa Mesa, CA · Remote

$80K - $110K/yr

Communicate regularly with executive leadership and clients regarding claims status and issues Required Qualifications * Some college coursework * Minimum five years medical claims adjudication ...

Jobs for Humanity

Medical Biller

Colorado Springs, CO · On-site

$18 - $23.25/hr

We're looking for a driven, entrepreneurial Account Executive to lead our revenue growth in Saudi ... Process and submit medical claims to insurance companies with precision and attention to detail

Jobs for Humanity

Medical Biller

Colorado Springs, CO · On-site

$18 - $23.25/hr

We're looking for a driven, entrepreneurial Account Executive to lead our revenue growth in Saudi ... Process and submit medical claims to insurance companies with precision and attention to detail

Jobs for Humanity

Medical Biller

Colorado Springs, CO · On-site

$18 - $23.25/hr

We're looking for a driven, entrepreneurial Account Executive to lead our revenue growth in Saudi ... Process and submit medical claims to insurance companies with precision and attention to detail

Aon Corporation

VP - Insurance, Claims & Strategy

NY · Remote

$250K - $275K/yr

Oversee day-to-day handling of D&O, Cyber, E&O, and related executive liability claims. * Develop ... medical, dental and vision insurance, various types of leaves of absence, paid time off, including ...

Aon

VP - Insurance, Claims & Strategy

Manhattan, NY · On-site

$250K - $275K/yr

Oversee day-to-day handling of D&O, Cyber, E&O, and related executive liability claims. * Develop ... medical, dental and vision insurance, various types of leaves of absence, paid time off, including ...

FMOLHS

Oncology Claims Analyst 1

Baton Rouge, LA

Experience: 3 years of medical revenue cycle experience Education: High School Diploma 1. Coding ... Advises the executive team on best practices for drug purchase opportunities to ensure potential ...

FMOLHS

Oncology Claims Analyst 2

Baton Rouge, LA

Three years of medical revenue cycle experience Education: Bachelor's degree or 5 years medical ... Advises the executive team on best practices for drug purchase opportunities to ensure potential ...

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Medical Claims Executive information

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How much do medical claims executive jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for medical claims executive in the United States is $22.21, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $24.52 per hour, depending on experience, location, and employer.

What does a medical claims executive do?

A Medical Claims Executive is responsible for processing and managing health insurance claims submitted by patients or healthcare providers. They review medical documentation, verify coverage, assess the validity of claims, and ensure that payments are made accurately and in accordance with policy guidelines. This role often involves communicating with healthcare providers, policyholders, and insurance underwriters to resolve discrepancies or gather additional information. Medical Claims Executives play a vital role in ensuring the claims process is efficient, accurate, and compliant with regulations.

What are the key skills and qualifications needed to thrive as a medical claims executive, and why are they important?

To excel as a Medical Claims Executive, you need a strong understanding of insurance policies, claims processing procedures, and medical terminology, often supported by a relevant degree or certification in health administration. Familiarity with claims management software, electronic health records (EHR), and regulatory compliance systems is essential for efficiency. Attention to detail, analytical thinking, and effective communication skills are crucial soft skills that help resolve issues and liaise with stakeholders. These competencies ensure accurate claims adjudication, minimize errors, and maintain positive relationships with clients and healthcare providers.

What are some common challenges faced by medical claims executives when handling complex claims, and how can these be managed effectively?

Medical Claims Executives often encounter challenges such as incomplete documentation, discrepancies in medical coding, and the need to interpret complex insurance policies. Managing these issues effectively requires strong attention to detail, up-to-date knowledge of healthcare regulations, and clear communication with healthcare providers and policyholders. Building strong relationships with team members, such as medical coders and underwriters, can also help streamline claim resolution and ensure accuracy. Staying organized and utilizing claims management software can further reduce errors and improve workflow.

What is the difference between Medical Claims Executive vs Medical Claims Specialist?

AspectMedical Claims ExecutiveMedical Claims Specialist
CredentialsTypically requires relevant certifications like CPC or CCS, with some managerial experienceRequires certifications such as CPC, with focus on claims processing skills
Work EnvironmentOften in managerial or supervisory roles within healthcare insurance companiesPrimarily in claims processing departments, handling claims review and adjudication
Employer & Industry UsageUsed in insurance companies, healthcare providers, and third-party administratorsCommonly employed in insurance companies, healthcare facilities, and billing firms

The Medical Claims Executive and Medical Claims Specialist roles share similar credentials and industry settings. However, the executive position typically involves oversight, decision-making, and managerial responsibilities, while the specialist focuses on processing and reviewing claims. Both roles are essential in healthcare insurance operations, with the executive often leading teams and strategizing claims management processes.

What are the most commonly searched types of Medical Claims jobs?

The most popular types of Medical Claims jobs are:

What states have the most Medical Claims Executive jobs?

States with the most job openings for Medical Claims Executive jobs include:

What are popular job titles related to Medical Claims Executive jobs?

For Medical Claims Executive jobs, the most frequently searched job titles are:

Infographic showing various Medical Claims Executive job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $46,198 per year, or $22.2 per hour.

Participant Claims Liaison

Olean, NY • On-site

community care of wny inc
See more jobs at community care of wny incexternal

Full-time

This job post has expired 3 days ago. Applications are no longer accepted.

Key responsibilities

  • Process medical claims received from providers for payment.

  • Review and verify medical records to ensure accuracy and completeness.

  • Manage claims inquiries, evaluate system coding, and handle underpayment/overpayment recovery processes.

Job description


PARTICIPANT CLAIMS LIAISON - Monday - Friday 8:30 - 4:30 35 hour week. No weekends, no major holidays. 

Exposure Category II

Basic Purpose and Scope

Under assigned supervision by the Associate Program Director/Center Manager, is responsible for, but not limited to processing medical claims and interacting with providers on a routine basis. 

Responsibilities 
  1. Processes medical claims received from Providers for payment. 
  2. Reviews and verifies medical records both electronic and hard copy ensuring accuracy and completeness.
  3. Evaluates system coding to validate pricing and claims payments to ensure claims are processed in accordance with provider contracts, participant benefits, and authorization requirements. 
  4. Manages claims inquiries and individual Provider requests. 
  5. Requests participant information/reports from specialist, health care facilities and other providers. 
  6. Analyze claims and data to improve operational efficiency, productivity, and accuracy. 
  7. Act as a subject matter expert for claims system functionality and capabilities. 
  8. Manage underpayment/overpayment recovery processes to ensure claims are reprocessed in a timely manner. 
  9. Monitor mis-paid claims, develop, and implement ongoing tracking mechanisms and recommend activities to reduce/avoid mis-paid claims from re-occurring. 
  10. Maintains confidentiality.
  11. Adheres to and reflects organizational values in daily work.
  12. Serves on agency committees as may be assigned.
  13. Maintains an obligation to report wrongdoing/violation of agency policies, applicable federal, state and local laws, and rules and regulations, pertaining to agency operations, to immediate supervisor or identified compliance officer.
  14. Completes all mandatory in-service education programs and completes any other additional in-service hours that are minimally required for the position. 

The above examples of work may not be a complete statement of all assignments that may be inherent to the position.  Other duties may be assigned as deemed necessary and appropriate by the Executive Program Officer, Associate Program Director, and/or Accounting Manager. 

Total Senior Care, Inc. reserves the right to add, delete or otherwise alter assigned duties at any time.   To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The minimum qualifications listed are representative of the knowledge, skill and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Requirements
  1. Required Education: Training and knowledge of medical records technology, claims processing, or equivalent program or high school diploma and four years of related experience in a medical records and/or medical claims processing environment, or equivalent combination of experience and education. 
  1. Required Experience:  2 years (or minimum of related experience above) of related work experience in a healthcare environment and processing of medical claims; skilled in computer operations and use/application of Microsoft Office software; and demonstrated organizational abilities. Possesses strong/broad understanding of the claims analyst process, medical terminology, and claims processing procedures.
  2. Desired or Preferred Knowledge, Skills and/or Abilities:  Effective verbal and written communication skills; strong attention to detail; organizational skills; customer service and telephone skills including receiving incoming calls and contacting external physician offices; familiarity and competence with standard office machines such as copier, calculator, fax machine, etc.; acceptable driver’s license and use of automobile during working hours. Healthcare experience in a managed care organization, preferred. 

Signature acknowledges review and receipt of job description.

Incumbent Name: ____________________________________ 

Incumbent Signature: _____________________________  Date:  ______________