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Medical Claims Negotiator Jobs (NOW HIRING)

The Reny Company

Medical Bill/Claim Negotiator

Plano, TX · On-site

$38K - $48K/yr (+ commission)

Monitoring In-Process Claims Report in order to meet each client's expected turnaround time. Contracting with medical providers by utilizing out of network claim on hand as well as cold calling ...

The Reny Company

Medical Claims Data Entry

Plano, TX · On-site

$17 - $20/hr

The Reny Company's healthcare claims data entry personnel is a professional who combines experience ... We specialize in medical bill review and negotiation services for workers compensation, non ...

CVS Health

Claims Negotiation Manager

$66K - $145K/yr

The Manager, Out-of-Network Claims Negotiation is responsible for leading the strategy, operations ... The benefits for this position include medical, dental, and vision coverage, paid time off ...

CVS Health

Claims Negotiation Manager

Farmington, CT

$66K - $145K/yr

The Manager, Out-of-Network Claims Negotiation is responsible for leading the strategy, operations ... The benefits for this position include medical, dental, and vision coverage, paid time off ...

Sedgwick Claims Management Services Ltd

$90 - $110/hr

To analyze complex or technically difficult medical malpractice claims including long term care ... Ideal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and ...

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Medical Claims Negotiator information

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$31

How much do medical claims negotiator jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for medical claims negotiator 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 is a medical claims negotiator?

A Medical Claims Negotiator is a professional who acts as a liaison between patients, healthcare providers, and insurance companies to resolve billing disputes and reduce out-of-pocket medical expenses. They review medical bills, insurance policies, and claim denials to ensure charges are accurate and to negotiate lower costs on behalf of patients or organizations. Their goal is to facilitate fair settlements, clarify coverage, and help clients navigate the complex healthcare billing system.

What are the key skills and qualifications needed to thrive as a medical claims negotiator?

A Medical Claims Negotiator needs a solid understanding of medical billing, insurance claims processes, and healthcare regulations, typically supported by experience in healthcare administration or claims management. Proficiency in claims management software, medical coding systems (such as ICD-10 and CPT), and familiarity with payer portals are commonly required. Strong negotiation, analytical thinking, and communication skills help professionals effectively resolve disputes and secure favorable outcomes for clients or organizations. Mastery of these skills ensures timely, cost-effective settlements and fosters positive relationships between patients, providers, and insurers.

What are some common challenges faced by medical claims negotiators when working with insurance companies and healthcare providers?

Medical Claims Negotiators often encounter challenges such as complex policy language, varying reimbursement rates, and resistance from both payers and providers during negotiations. Balancing the interests of patients, insurance companies, and healthcare providers requires strong communication and problem-solving skills. Additionally, negotiators must stay updated on healthcare regulations and industry trends to effectively advocate for fair settlements. Building relationships and maintaining professionalism under pressure are key to overcoming these challenges and securing optimal outcomes.

What is the difference between Medical Claims Negotiator vs Medical Billing Specialist?

AspectMedical Claims NegotiatorMedical Billing Specialist
CredentialsCertification in claims or insurance processing often preferredCertification in medical billing or coding often preferred
Work EnvironmentInsurance companies, healthcare providers, or third-party payersHospitals, clinics, or medical offices
Primary FocusNegotiating claim settlements and maximizing reimbursementsPreparing and submitting medical bills and coding claims

The Medical Claims Negotiator primarily focuses on negotiating insurance claims and settlements, while the Medical Billing Specialist handles billing, coding, and submitting claims. Both roles require knowledge of insurance processes, but their core responsibilities differ, with negotiators emphasizing reimbursement negotiations and billing specialists managing claim submissions.

Is claims processing a stressful job?

Medical Claims Negotiators often find claims processing to be a demanding task due to strict deadlines, detailed documentation, and the need for accuracy. The job requires strong organizational skills and attention to detail, which can contribute to stress levels, especially during high workload periods or complex cases.

What cities are hiring for Medical Claims Negotiator jobs?

Cities with the most Medical Claims Negotiator job openings:

What states have the most Medical Claims Negotiator jobs?

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

Medical Claims Negotiator jobs near you
Infographic showing various Medical Claims Negotiator 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.

Medical Claims Processor

Vanguard Group Staffing

White Plains, NY • On-site

$24 - $30/hr

Temporary

PTO

This job post has expired today. Applications are no longer accepted.

Job description

Long Term Temporary, Possible Temporary- to -Direct Hire Medical Billing/Claims Coordinator - Monday through Friday, 9am to 5pm, Fully On-Site.

  • Communicate via telephone and written correspondence with providers, members, attorneys, and collection agencies to resolve balance billing/fee negotiation inquiries.
  • Handle large call volume.
  • Negotiate and resolve balance billing inquires, negotiate fees and discounts for members with nonparticipating providers to reduce out of pocket expenses.
  • Analyze correspondence; verify member eligibility, claim history and coordination of benefits.
  • Review claims to determine if appropriate action was taken; follow up with Claims and Recovery Units to initiate adjustments and recover money.
  • Identify billing anomalies and alert the Fraud and Abuse Department to reduce fraudulent billing practices.
  • Triage balance billing/fee negotiation inquiries and ensure all documents are processed in a timely and efficient manner.
  • Research provider contracts and lease network reports to ensure providers are not breaching contracts by referring members out of network.
  • Perform additional duties and projects as assigned by management.
Vanguard Staffing logo

About Vanguard Staffing

Sourced by ZipRecruiter

For more than 50 years, Vanguard has provided reliable, hands-on recruiting services to the entertainment, finance, banking, media, advertising industries, health care industries and more. Founded in New York City in 1970, Vanguard provides staffing services throughout the Tri-State area. As accounting and finance, administrative clerical and freelance creative graphic design recruiters, we understand the importance of working together as a team in all aspects of our business. And we communicate openly with staff, clients, and the people that we place.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Stamford, CT, US

Year founded

1969

Social media

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