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Medical Claims Processor Jobs in Merced, CA (NOW HIRING)

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$14

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$27

How much do medical claims processor jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for medical claims processor in Merced, CA is $20.56, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $22.84 per hour, depending on experience, location, and employer.

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 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.

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 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.

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 positions may offer on-the-job training or certification programs.
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What are the most commonly searched types of Medical Claims Processor jobs in Merced, CA?

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What cities near Merced, CA are hiring for Medical Claims Processor jobs?

Cities near Merced, CA with the most Medical Claims Processor job openings:

Medical Claims Processor jobs near you
Infographic showing various Medical Claims Processor job openings in Merced, CA as of August 2026, with employment types broken down into 65% Full Time, 17% Temporary, and 18% Contract. Highlights an 60% In-person, 20% Hybrid, and 20% Remote job distribution, with an average salary of $42,762 per year, or $20.6 per hour.

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Patriot Conceptions

Merced, CA • On-site

$120K/yr

Other

Posted 13 days ago

Job description

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