ZipRecruiter

Log In

1

Medical Claims Processing Jobs in Virginia (NOW HIRING)

C-MCI

Medical Billing Specialist

Fairfax, VA · On-site +1

$18.50 - $24/hr

CMCI is seeking a detail-oriented and experienced Medical Billing Specialist to oversee claims processing, revenue cycle management, and contribute valuable insights to develop AI-powered tools that ...

Crawford and Company

Claims Specialist-WC

Fairfax, VA · On-site

$16.10 - $29.44/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Works closely with claimants, witnesses and members of the medical profession and other persons pertinent to the investigation and processing of claims. * Verifies policy coverage for submitted ...

Trice Healthcare

Coding Payment Resolution Spec

Richmond, VA · On-site

$18.50 - $23.75/hr

... claims, or other coding reasons and processing charge corrections based on medical record reviews, contracts, regulations as directed by the Supervisor Clinical / Coding Payment Resolution.

Tata Consultancy Service Limited

Claims Consultant

Henrico, VA · On-site

$48K - $55K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

To provide Absence case management and claim adjudications, based on medical documentation and the ... Reviews client critical deliverables, manages the overall workload, and second-level process ...

AppleOne

FHA VA Claims Associate

Virginia Beach, VA · Remote

$28/hr

  • Medical

  • Dental

  • Vision

  • Retirement

... leadership focused on quality, process improvement, and successful team performance. Key ... medical, dental, vision, 401k and any statutory sick pay where required. We are committed to ...

Kinsale Insurance

Claims Examiner

Richmond, VA

$73K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct and coordinate investigations across all phases of the claims process * Evaluate liability ... Ability to analyze medical records, contracts (including risk transfer provisions), property damage ...

Kinsale Management, Inc

Claims Examiner

Richmond, VA · On-site

$73K - $90K/yr

Conduct and coordinate investigations across all phases of the claims process * Evaluate liability ... Ability to analyze medical records, contracts (including risk transfer provisions), property damage ...

Kinsale Insurance

Claims Examiner

Richmond, VA · On-site

$73K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct and coordinate investigations across all phases of the claims process * Evaluate liability ... Ability to analyze medical records, contracts (including risk transfer provisions), property damage ...

Dollar Tree

Director, Claims Litigation

Chesapeake, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilize tools to manage tender, subrogation and recovery processes. * Coordinate and set procedures ... Knowledge of medical terminology, medical treatment protocols, and legal proceedings * Ability to ...

Dollartree

Director, Claims Litigation

Chesapeake, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilize tools to manage tender, subrogation and recovery processes. * Coordinate and set procedures ... Knowledge of medical terminology, medical treatment protocols, and legal proceedings * Ability to ...

next page

Showing results 1-20

All JobsMedical Claims Processing JobsMedical Claims Processing Jobs in Virginia

Medical Claims Processing information

See Virginia salary details

$13

$19

$25

How much do medical claims processing jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for medical claims processing in Virginia is $19.30, according to ZipRecruiter salary data. Most workers in this role earn between $17.16 and $21.44 per hour, depending on experience, location, and employer.

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.

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 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.

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.

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.

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.

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

The most popular types of Medical Claims Processing jobs in Virginia are:

What are popular job titles related to Medical Claims Processing jobs in Virginia?

For Medical Claims Processing jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Medical Claims Processing jobs in Virginia look for?

The top searched job categories for Medical Claims Processing jobs in Virginia are:

What cities in Virginia are hiring for Medical Claims Processing jobs?

Cities in Virginia with the most Medical Claims Processing job openings:

Medical Claims Processing jobs near you
Infographic showing various Medical Claims Processing job openings in Virginia as of August 2026, with employment types broken down into 73% Full Time, 12% Part Time, and 15% Contract. Highlights an 93% In-person, and 7% Remote job distribution, with an average salary of $40,146 per year, or $19.3 per hour.

Medical Billing Specialist

C-MCI

Fairfax, VA • On-site, Remote

$18.50 - $24/hr

Full-time

Re-posted 12 days ago

Job description


Position: Medical Billing Specialist
Location: Remote / On-site
Department: Revenue Cycle Management
Overview:
CMCI is seeking a detail-oriented and experienced Medical Billing Specialist to oversee claims processing, revenue cycle management, and contribute valuable insights to develop AI-powered tools that enhance medical billing workflows. The ideal candidate will have expertise in medical coding, claims submission, payer interactions, and denial management, ensuring optimized billing practices for maximum reimbursement and minimal claim rejections.
Why Join CMCI?
  • Opportunityto work with cutting-edge AI-driven billing solutions that optimizeRCM efficiency.
  • Work in acollaborative environment with healthcare and AI professionals.
  • Competitivesalary, benefits, and professional development opportunities.

Key Responsibilities:
  • ClaimsProcessing & Submission:
    • Accuratelyprocess, review, and submit medical claims.
    • Verify CPT,ICD-10, and HCPCS codes to ensure claims compliance withpayer-specific policies.
    • Work withclearinghouses and insurance payers to track claims and resolve denials,rejections, and underpayments efficiently.
  • Revenue CycleManagement (RCM):
    • Oversee theentire claims lifecycle, from eligibility verification to final paymentreconciliation.
    • Monitoraccounts receivable (A/R) aging reports and ensure timely follow-upon outstanding claims.
    • Optimizepayer reimbursement rates by leveraging contractual agreements andcoding best practices.
  • Payer &Compliance Coordination:
    • Utilize thepayer lookup database to retrieve Payer IDs and transactiontypes for accurate claim submission.
    • Ensurecompliance with Medicare, Medicaid, and private insuranceguidelines to prevent fraud and billing errors.
    • Stay updatedon coding changes, regulatory requirements, and payer policies tomaintain accuracy in claims processing.
  • Technology& AI Development Support:
    • Provideinsights into billing workflows, common claim errors, and automationopportunities to improve AI-driven billing tools.
    • Assist intesting and refining AI-powered RCM solutions, including automated claimsscrubbing and predictive denial management.
    • Collaboratewith the engineering and data science teams to train AI models forenhanced claims accuracy.

Requirements
Required Qualifications:
  • Education& Certification:
    • Associate'sor Bachelor's degree in Health Information Management, Business, or arelated field (preferred).
    • CertifiedProfessional Biller (CPB) or Certified Professional Coder(CPC) (preferred).
  • Experience:
    • 2+ years ofexperience in medical billing, claims processing, or revenue cyclemanagement.
    • Strongknowledge of CPT, ICD-10, and HCPCS coding systems.
    • Experienceworking with Medicare, Medicaid, and commercial insurance payers.
  • TechnicalSkills:
    • Proficiencywith billing and practice management software such as:
      • ElectronicHealth Records Systems: Epic, Cerner, Athenahealth
      • Clearinghouseplatforms: Emdeon, Availity, Change Healthcare, Waystar, Kareo
    • Experiencewith ANSI X12 837 EDI claims processing.
    • Strong Exceland data analysis skills for tracking claim performance.
    • Familiaritywith AI-based RCM tools is a plus.
  • Soft Skills:
    • Stronganalytical and problem-solving skills for identifying claimdiscrepancies.
    • Excellentcommunication and collaboration skills to liaise with providers andpayers.
    • Ability towork independently and in a team environment in a fast-pacedsetting.

Join CMCI to help revolutionize the future of AI-powered medical billing!
All qualified applicants will receive consideration for employment without regard to any characteristic protected by local, state, or federal laws, rules, or regulations

Apply