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Medical Claims Processing Jobs (NOW HIRING)

Karna, LLC

$20 - $25/hr

Minimum of 5 years' experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims* Candidates must be located in one of the following ...

KARNA LLC

$22 - $25/hr

Minimum of 5 years' experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims* Candidates must be located in one of the following ...

Karna LLC

Experienced Healthcare Claims Processor

$22 - $25/hr

Minimum of 5 years' experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims* Candidates must be located in one of the following ...

TEEMA

Claims Reviewer

Phoenix, AZ · Remote

$26.40 - $27.88/hr

Work closely with medical directors, providers, peer reviewers, and various internal teams. Key Responsibilities * Review and validate claims using established criteria and processing guidelines.

Insperity

Medical Claims Examiner

Los Angeles, CA · On-site +1

$20 - $25/hr

Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines ... medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or ...

KARNA LLC

$20 - $25/hr

Minimum of 5 years' experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims* Candidates must be located in one of the following ...

Insperity

Medical Claims Examiner

CA · On-site +1

$20 - $25/hr

Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines ... medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or ...

Searhc

Medical Claims Specialist

Juneau, AK

$25 - $28.45/hr

Mental fatigue exists with the high level of concentration necessary to properly process medical claims for payment accurately and timely. The employee must be able to work under stressful conditions.

Imagenet

Claims Examiner - Remote

Tampa, FL · Remote

As a Claims Examiner, you will be responsible for accurately reviewing, investigating, and processing medical claims and provider dispute requests in accordance with payer guidelines, contractual ...

Pride Health

Claims Processor

Manhattan, NY · On-site

$30 - $33/hr

This role is responsible for the accurate and timely processing of provider medical claims, ensuring compliance with company policies and contractual guidelines. The ideal candidate will have ...

ImageNetLLC

Claims Examiner - Remote

Tampa, FL · Remote

As a Claims Examiner, you will be responsible for accurately reviewing, investigating, and processing medical claims and provider dispute requests in accordance with payer guidelines, contractual ...

ImagenetLLC

Claims Examiner - Remote

Tampa, FL · Remote

As a Claims Examiner , you will be responsible for accurately reviewing, investigating, and processing medical claims and provider dispute requests in accordance with payer guidelines, contractual ...

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Medical Claims Processing information

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How much do medical claims processing jobs pay per hour?

As of Jul 21, 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.

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.

How to become a medical claims processor?

To become a medical claims processor, candidates typically need a high school diploma or equivalent, along with training in medical billing and coding. Many employers prefer familiarity with claims processing software and knowledge of healthcare regulations, and some roles may require certification such as the Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS).

Is it hard to get hired as a medical biller?

Getting hired as a medical biller generally requires relevant training or certification, attention to detail, and familiarity with billing software and healthcare regulations. Job availability can vary based on location and experience, but entry-level positions are often accessible with proper skills and certifications such as CPC or CPC-A. Strong organizational skills and understanding of insurance processes improve employment prospects.

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 highest paying adjuster job?

The highest paying adjuster jobs are typically senior or specialized roles such as catastrophe or large-loss adjusters, who handle complex claims and often work for major insurance companies. These positions usually require extensive experience, industry certifications like the Chartered Property Casualty Underwriter (CPCU), and may involve working long hours or in high-stress environments.

What healthcare jobs pay over $100k per year?

In medical claims processing, senior roles such as Claims Manager or Director can earn over $100,000 annually, especially with extensive experience and certifications. Other high-paying healthcare jobs include physicians, surgeons, and specialized healthcare administrators, which often require advanced degrees and specialized skills.
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:
What states have the most Medical Claims Processing jobs? States with the most job openings for Medical Claims Processing jobs include:
What job categories do people searching Medical Claims Processing jobs look for? The top searched job categories for Medical Claims Processing jobs are:
Medical Claims Processing jobs near you
Infographic showing various Medical Claims Processing job openings in the United States as of July 2026, with employment types broken down into 90% Full Time, 8% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $40,493 per year, or $19.5 per hour.
Medical Claims Reviewer

Medical Claims Reviewer

OSI VISION LLC

Joint Base San Antonio (randolph), TX • On-site

Other

Re-posted 17 days ago

Job description

About the Role

Osi Vision LLC is seeking Medical Claims Reviewers to support the Air Force Security Assistance and Training (AFSAT) Squadron at Randolph AFB. In this role you will monitor the welfare of U.S. Air Force-sponsored international students by reviewing and adjudicating their medical, dental, and pharmacy claims - ensuring accurate coding, appropriate reimbursement, and compliance with U.S. Air Force insurance processes.

This is a detail-oriented, mission-critical position. You will be the primary point of contact between treatment facilities and AFSAT's financial management function (AFSAT/FMF), and you will be expected to identify and resolve discrepancies, explain insurance processes to providers, and advocate for cost reductions on behalf of the program.

Primary Responsibilities

  • Review medical, dental, and pharmacy claims for International Military Students (IMS) and their dependents against payer policies, ICD-10 coding guidelines, and medical necessity standards.
  • Receive, track, and verify pre-authorization requests; resolve discrepancies and communicate outcomes to treatment facilities.
  • Verify that ICD codes on submitted claims comply with the treating provider's documented diagnosis, using current ICD guidance.
  • Advocate for reduced treatment costs and prepare validated claims for submission to AFSAT/FMF for processing.
  • Explain IMS medical insurance processes and Invitational Travel Order (ITO) coverage to treatment facilities and coordinate with the base TRICARE Office as needed.
  • Become familiar with the Defense Security Assistance Management System (DSAMS) and proficient in Security Assistance Network Web (SANWeb) within 90 days of employment.
  • Maintain accurate records and produce clear written reports on claims activity, discrepancies, and resolutions.

Knowledge & Experience Requirements

Required:

  • 2+ years of direct medical claims processing or adjudication experience.
  • 1+ year of medical claims experience in a DoD or U.S. Air Force setting (military treatment facility, TRICARE, or DoD contractor supporting medical claims).
  • Working knowledge of ICD-10-CM, CPT procedure codes, and HCPCS codes and how they relate to medical necessity and accurate reimbursement.
  • Familiarity with medical terminology, insurance terminology, payer policies, and healthcare delivery systems.
  • Proficiency with Microsoft Office applications (Word, Excel, PowerPoint, Access) and Windows 10 or later.
  • Ability to read and interpret technical procedures, governmental regulations, and payer policy documents.
  • Strong written and verbal communication skills; ability to explain complex insurance concepts clearly to non-specialists.

Preferred:

  • Direct experience with CHCS, AHLTA, or MHS GENESIS military health information systems.
  • Familiarity with TRICARE authorization requirements and coordination-of-benefits rules.
  • Experience in a claims environment involving international patients or government-sponsored travel programs.
  • Existing CPC, CCS, RHIT, or equivalent coding credential.


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