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Medical Claims Processing Jobs (NOW HIRING)

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Medical Claims Analyst

Juneau, AK · On-site

$31.83 - $44.56/hr

This role performs claims review and processing, eligibility verification, referral validation ... Performs all duties of the Medical Claims Specialist role, including review, screening, eligibility ...

Datamark, Inc.

Medical Claims Processor

El Paso, TX · On-site

$16.50/hr

Team as a Medical Claims Processor! Are you looking for an exciting opportunity where your ... and accurate prescription processing. This is a back-office position that requires strong ...

Datamark, Inc.

Medical Claims Processor

El Paso, TX · On-site

$16.50/hr

Team as a Medical Claims Processor! Are you looking for an exciting opportunity where your ... and accurate prescription processing. This is a back-office position that requires strong ...

Datamark, Inc.

Medical Claims Processor

El Paso, TX · On-site

$16.50/hr

Team as a Medical Claims Processor! Are you looking for an exciting opportunity where your ... and accurate prescription processing. This is a back-office position that requires strong ...

Next Step Systems

Medical Claims Coder

Tucson, AZ · On-site

Maximize reimbursement and develop effective policies for billing and claim processing. This position is 100% Onsite and NOT open for Remote. Medical Claims Coder Responsibilities: - Submit claims ...

Next Step Systems

Medical Claims Coder

Tucson, AZ · On-site

Maximize reimbursement and develop effective policies for billing and claim processing. This position is 100% Onsite and NOT open for Remote. Medical Claims Coder Responsibilities: - Submit claims ...

Vanguard Group Staffing

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Medical Claims Processor

White Plains, NY · On-site

$24 - $30/hr

Long Term Temporary, Possible Temporary- to -Direct Hire Medical Billing/Claims Coordinator ... Triage balance billing/fee negotiation inquiries and ensure all documents are processed in a timely ...

Next Step Systems

Medical Claims Examiner

Tucson, AZ · On-site

Maximize reimbursement and develop effective policies for billing and claim processing. This position is 100% Onsite and NOT open for Remote. Medical Claims Examiner Responsibilities: - Submit claims ...

NTT Data Americas, Inc.

Medical Claims Processor

$17 - $18/hr

Processing of Professional and Hospital claim forms files by provider * Reviewing the policies and ... s) of Medical Claims experience * 2+ year(s) using a computer with Windows applications that ...

NTT DATA

Medical Claims Processor

$17 - $18/hr

... processing of professional and hospital claim forms files by provider. Reviewing the policies and ... Required skills for this role include 2+ year(s) of medical claims experience and 2+ year(s) using ...

Next Step Systems

Medical Claims Examiner

Tucson, AZ · On-site

Maximize reimbursement and develop effective policies for billing and claim processing. This position is 100% Onsite and NOT open for Remote. Medical Claims Examiner Responsibilities: - Submit claims ...

IQVIA

Medical Biller/Claims Processing

Las Vegas, NV · Remote

$23/hr

Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...

IQVIA

Medical Biller/Claims Processing

Houston, TX · Remote

$23/hr

Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...

Next Step Systems

Medical Claims Examiner

Tucson, AZ · On-site

Medical Claims Examiner, Tucson, AZ The responsibilities of the Medical Claims Examiner consist of processing claims data and adjudicating medical and inpatient claims received from all provider ...

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Medical Claims Processing information

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How much do medical claims processing jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for medical claims processing in the United States is $19.47, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $21.63 per hour, depending on experience, location, and employer.

What are some common challenges faced in medical claims processing, and how can professionals address them?

Medical claims processors often encounter challenges such as handling complex insurance policies, navigating frequent regulatory changes, and ensuring the accuracy of coding and billing information. To address these issues, professionals need to stay updated with industry regulations, maintain strong attention to detail, and communicate effectively with healthcare providers and insurance companies. Ongoing training and the use of specialized software can also help streamline workflows and minimize errors, making the process more efficient.

What is medical claims processing?

Medical claims processing is the administrative procedure of reviewing, validating, and handling healthcare claims submitted by providers to insurance companies or payers for reimbursement. This process involves checking the accuracy of the submitted information, verifying patient eligibility and coverage, and ensuring that services are medically necessary and properly coded. Claims processors work to approve, deny, or request additional information to resolve claims, ultimately ensuring that healthcare providers receive payment and patients are billed accurately.

Do you need a degree to be a medical claims processor?

A degree is not typically required to become a medical claims processor, but employers often prefer candidates with a high school diploma or equivalent. Relevant skills include knowledge of medical billing, coding, and claims processing software, and some certifications can enhance job prospects.

What is the difference between Medical Claims Processing vs Medical Billing?

AspectMedical Claims ProcessingMedical Billing
CredentialsTypically requires knowledge of insurance policies and claims proceduresRequires understanding of coding and billing practices
Work EnvironmentOften in insurance companies, healthcare providers, or claims processing centersPrimarily in healthcare provider offices or billing companies
Employer & IndustryInsurance companies, healthcare providers, third-party administratorsHospitals, clinics, medical practices, billing services

Medical Claims Processing focuses on reviewing and submitting insurance claims for reimbursement, ensuring compliance with policies. Medical Billing involves coding patient services and generating bills for patients and insurers. While related, Claims Processing emphasizes claim review and approval, whereas Billing centers on creating accurate invoices for services rendered.

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

To thrive as a Medical Claims Processor, you need a solid understanding of medical terminology, insurance policies, and claims procedures, often supported by a high school diploma or associate degree. Familiarity with claims management software, healthcare coding systems (ICD-10, CPT), and electronic health record (EHR) systems is typically required. Attention to detail, strong organizational skills, and effective communication help ensure accuracy and timely processing. These skills are crucial for minimizing errors, reducing claim denials, and supporting efficient healthcare reimbursement processes.

How to get a job as a medical claims processor?

To become a medical claims processor, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary training in healthcare administration or related fields. Relevant skills include attention to detail, knowledge of medical billing and coding, and proficiency with claims processing software. Certification such as the Certified Medical Reimbursement Specialist (CMRS) can improve job prospects, and previous experience in healthcare or insurance is often beneficial.
More about Medical Claims Processing jobs
What cities are hiring for Medical Claims Processing jobs? Cities with the most Medical Claims Processing job openings:
What are the most commonly searched types of Medical Claims Processing jobs? The most popular types of Medical Claims Processing jobs are:
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Medical Claims Processing jobs near you
Infographic showing various Medical Claims Processing job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $40,493 per year, or $19.5 per hour.

Claims Specialist II (Medical Claims / Coordination of Benefits)

Strategic Staffing Solutions

Baton Rouge, LA • Remote

$19/hr

Other

Medical

Posted 9 days ago

Job description

Job Description Claims Specialist II (Medical Claims / Coordination of Benefits) Location: Remote (Louisiana Preferred) Contract Length: 5 Months Pay Rate: Up to $19/hour (W2) Industry: Health Insurance / Medical Claims Position Summary We are seeking an experienced Claims Specialist II with medical claims processing experience to support a high-volume health insurance claims operation. This position is responsible for processing and adjusting medical claims, researching claim issues, determining Coordination of Benefits (COB), recovering overpayments, and ensuring claims are processed accurately while maintaining compliance with HIPAA and company policies. Louisiana candidates are preferred.

This is a remote opportunity. Required Qualifications High School Diploma or equivalent Minimum 2 years of medical claims processing experience Claims processing experience is required Coordination of Benefits (COB) experience strongly preferred Experience determining primary vs. secondary insurance coverage Knowledge of medical claims adjudication and claims edits Strong analytical, problem-solving, and investigative skills Excellent verbal and written communication skills Working knowledge of Microsoft Office and claims processing systems Ability to prioritize multiple workstreams in a fast-paced environment Preferred Experience Hands-on Coordination of Benefits (COB) processing Medicare coordination and primacy determination Provider reimbursement and overpayment recovery Health insurance or managed care environment Key Responsibilities Process medical claims, claims edits, and claims adjustments accurately.

Research and determine the correct Coordination of Benefits (COB) for members with multiple insurance plans. Identify primary and secondary coverage using subscriber status, plan type, Medicare coordination, and effective dates. Review and update claims to ensure proper payment and reimbursement.

Investigate and resolve complex claims issues and discrepancies. Process refunds and recover overpayments from providers or members. Communicate with providers, members, Medicare, and other insurance carriers regarding claim status and coverage.

Maintain accurate claims records while ensuring compliance with HIPAA and regulatory requirements. Review quality audits and complete corrections within departmental guidelines. Support special projects, training initiatives, and departmental process improvements.

Preferred Knowledge Medical claims adjudication Coordination of Benefits (COB) Medicare primacy rules Provider reimbursement Claims adjustments and overpayment recovery HIPAA compliance Medical terminology Health insurance operations Ideal Background Candidates with experience in organizations such as: Blue Cross Blue Shield UnitedHealthcare / Optum Humana Elevance Health (Anthem) Aetna / CVS Health Cigna Centene Molina Healthcare Kaiser Permanente Highmark GuideWell / Florida Blue CareFirst HealthPartners AmeriHealth This opportunity is ideal for candidates with strong medical claims processing and Coordination of Benefits (COB) experience who thrive in a detail-oriented, production-focused healthcare environment.

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