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Medical Claims Processor Jobs in Chicago, IL (NOW HIRING)

Captive Resources

Underwriter

Itasca, IL

$100K - $135K/hr

Experience with medical claims analysis, pricing, and risk management is essential. SKILLS ... Support the sales team by providing underwriting insights and assisting with the proposal process ...

Captive Resources

Underwriter

Itasca, IL · On-site

$100K - $135K/hr

Experience with medical claims analysis, pricing, and risk management is essential. SKILLS ... Support the sales team by providing underwriting insights and assisting with the proposal process ...

Captive Resources

Underwriter

Itasca, IL · On-site +1

Experience with medical claims analysis, pricing, and risk management is essential. SKILLS ... Support the sales team by providing underwriting insights and assisting with the proposal process ...

Physician Billing Specialists, LLC

Be Seen First

Medical Billing, Certified Coder

Park Ridge, IL · Remote

$17 - $19/hr

... clean claims to insurance companies. · Processes and applies collected copayments to claims. · Answers phone questions from patients, clients, insurance companies, and other sources. · ...

Gallagher

Claims Advocate

Rolling Meadows, IL

This new team is equipped with experts, processes and solutions to help you meet the evolving ... Medical/dental/vision plans, which start from day one! * Life and accident insurance * 401(K) and ...

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All JobsMedical Claims Processor JobsMedical Claims Processor Jobs in Chicago, IL

Medical Claims Processor information

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How much do medical claims processor jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for medical claims processor in Chicago, IL is $20.05, according to ZipRecruiter salary data. Most workers in this role earn between $17.84 and $22.31 per hour, depending on experience, location, and employer.

What are some common challenges faced by medical claims processors, and how can they be managed?

Medical Claims Processors often encounter challenges such as handling complex insurance policies, keeping up with changing regulations, and resolving claim discrepancies. To manage these issues, strong attention to detail, continuous learning, and effective communication with providers and insurance representatives are essential. Many processors also rely on updated software and regular training to stay current with industry standards and maintain accuracy in claim adjudication.

What is a medical claims processor?

Medical claims processors work for a health care office or insurance company. Their job is to check medical insurance claims for proper billing codes, update the doctor or insurer about changes to the claim, and clarify concerns about patient benefits. It is essential that the billing codes match the medical services provided. As a medical claims processor, you also follow up with the insurer to discuss discrepancies and find out the status of claims. Current procedural terminology (CPT) and data entry are central parts of a medical claims processor’s job, as they often use Microsoft Office applications or a secure database to enter billing codes for services rendered.

What does a medical claims processor do?

A Medical Claims Processor is responsible for reviewing, evaluating, and processing health insurance claims submitted by policyholders or healthcare providers. Their main tasks include verifying patient and insurance information, examining medical codes, ensuring compliance with insurance policies, and determining the amount payable for each claim. They play a crucial role in making sure that claims are handled efficiently and accurately, helping both providers and patients navigate insurance benefits. Attention to detail, knowledge of medical terminology, and understanding insurance guidelines are essential skills for this role.

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

AspectMedical Claims ProcessorMedical Billing Specialist
CredentialsHigh school diploma; certification optionalHigh school diploma; certification often preferred
Work EnvironmentHealthcare offices, insurance companiesMedical offices, billing companies
Primary FocusReviewing and processing insurance claimsCreating and sending bills to patients and insurers
Common TasksVerifying claim accuracy, data entryCoding procedures, invoicing patients

While both roles involve handling healthcare financial data, Medical Claims Processors focus on reviewing and submitting insurance claims, whereas Medical Billing Specialists handle invoicing and billing patients. Both roles require attention to detail and knowledge of healthcare billing processes, but their daily tasks and focus areas differ.

Is a medical claims processor job in demand?

Medical claims processor jobs are in demand due to the ongoing need for healthcare administration and insurance processing. The role requires attention to detail and familiarity with claims processing software, and employment is expected to grow as healthcare coverage expands and insurance companies seek qualified staff.

What do you need to be a medical claims processor?

To become a medical claims processor, you typically need a high school diploma or equivalent, strong attention to detail, and familiarity with medical billing and coding software. Some employers prefer candidates with certification in medical billing or coding, such as the Certified Professional Coder (CPC). Good organizational skills and the ability to work with sensitive information are also important.

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, health insurance policies, and claims adjudication processes, often supported by a high school diploma or associate degree. Proficiency with claims management software, ICD and CPT coding systems, and electronic health record systems is typically required. Attention to detail, organizational skills, and the ability to communicate clearly with providers and patients are essential soft skills. These competencies ensure accurate claim processing, minimize errors, and help maintain efficient workflow within healthcare administration.
More about Medical Claims Processor jobs
What are the most commonly searched types of Medical Claims Processor jobs in Chicago, IL? The most popular types of Medical Claims Processor jobs in Chicago, IL are:
Medical Claims Processor jobs near you
Infographic showing various Medical Claims Processor job openings in Chicago, IL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 50% In-person, and 50% Hybrid job distribution, with an average salary of $41,714 per year, or $20.1 per hour.

Claims Representative - Liability | Auto | Jurisdiction: All States | Licensing: TX/FL preferred (Hy

Sedgwick

Naperville, IL • On-site

$49 - $58K/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

Sedgwick rating

7.6

Company rating: 7.6 out of 10

Based on 321 frontline employees who took The Breakroom Quiz

208th of 304 rated insurance

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
Claims Representative - Liability | Auto | Jurisdiction: All States | Licensing: TX/FL preferred (Hybrid - Downers Grove, IL)
Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?
  • Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.
  • Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
WORK LOCATIONS: Hybrid work schedule in the Downers Grove, IL Sedgwick office, 3 days remote 2 days in office.
PRIMARY PURPOSE OF THE ROLE :To process low level auto liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
  • Processes low level auto liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
  • Develops and coordinates low level auto liability claims' action plans to resolution, return-to-work efforts, and approves claim payments.
  • Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
  • Administers subrogation of claims and negotiates settlements.
  • Communicates claim action with claimant and client.
  • Ensures claim files are properly documented and claims coding is correct.
  • May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
  • Maintains professional client relationships.
  • Performs other duties as assigned.
  • Supports the organization's quality program(s).
  • Travels as required.

QUALIFICATIONS
Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
Experience: 2 years of claims management experience or equivalent combination of education and experience required.
Licensing / Jurisdiction Knowledge:
TAKING CARE OF YOU
  • Flexible work schedule.
  • Referral incentive program.
  • Career development and promotional growth opportunities.
  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

WORK ENVIRONMENT REQUIREMENTS INCLUDE
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($49-$58k). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
#claimsexaminer #claims #hybrid
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

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