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Medical Claims Processor Jobs in Rochester, NY (NOW HIRING)

Angels In Your Home

Medical Biller

Rochester, NY · Remote

$20 - $25/hr

Stay informed of billing requirements, payer updates, and process changes that may impact claims ... or medical claims processing preferred. * Experience with LHCSA, home care, or long-term care ...

Angels In Your Home

Medical Biller

Rochester, NY · On-site

$20 - $25/hr

Stay informed of billing requirements, payer updates, and process changes that may impact claims ... or medical claims processing preferred. * Experience with LHCSA, home care, or long-term care ...

Angels In Your Home LHCSA

Medical Biller

Rochester, NY · On-site

$20 - $25/hr

Stay informed of billing requirements, payer updates, and process changes that may impact claims ... or medical claims processing preferred. * Experience with LHCSA, home care, or long-term care ...

Tata Consultancy Service Limited

Claims Consultant

Rochester, NY · 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 ...

Acrisure

Workers' Compensation Claims Consultant

Rochester, NY · On-site

$75K - $85K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... claims processes and following up with the client at the conclusion of the claim to ensure all ... Comprehensive medical insurance, dental insurance, and vision insurance; life and disability ...

Progressive

Claims Adjuster Trainee

Rochester, NY · Hybrid

$60K - $63K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... the claims process from start to finish. You'll have the support of a collaborative team and ... Medical, dental & vision, including free preventative care * Wellness & mental health programs

Primma, LLC

Complex Claims Specialist

Rochester, NY · On-site

$127K - $148K/yr

General Summary: A Complex Claims Specialist will possess experience in handling complex medical liability claims, while demonstrating a strong client service focus. Essential Duties ...

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All JobsMedical Claims Processor JobsMedical Claims Processor Jobs in Rochester, NY

Medical Claims Processor information

See Rochester, NY salary details

$13

$19

$25

How much do medical claims processor jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for medical claims processor in Rochester, NY is $19.21, according to ZipRecruiter salary data. Most workers in this role earn between $17.07 and $21.35 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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The most popular types of Medical Claims Processor jobs in Rochester, NY are:

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For Medical Claims Processor jobs in Rochester, NY, the most frequently searched job titles are:

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The top searched job categories for Medical Claims Processor jobs in Rochester, NY are:

Medical Claims Processor jobs near you
Infographic showing various Medical Claims Processor job openings in Rochester, NY as of August 2026, with employment types broken down into 64% Full Time, 17% Temporary, and 19% Contract. Highlights an 59% In-person, 20% Hybrid, and 21% Remote job distribution, with an average salary of $39,953 per year, or $19.2 per hour.

Medical Biller

Angels In Your Home

Rochester, NY • Remote

$20 - $25/hr

Full-time

Re-posted 22 days ago

Job description

Description

 Angels In Your Home, a licensed home care services agency serving individuals across New York State, is seeking a detail-oriented and reliable Billing Specialist / Home Care Biller to join our administrative team.

This is a full-time position responsible for supporting accurate and timely billing, claims submission, payment follow-up, and account reconciliation for home care services. The Billing Specialist / Home Care Biller will work collaboratively with internal departments, payers, managed care plans, insurance representatives, and other stakeholders to ensure billing processes are completed accurately, efficiently, and in accordance with payer requirements and agency procedures.


Primary responsibilities include:

  • Prepare, review, and submit billing claims for home care services in accordance with payer requirements, agency procedures, and applicable regulations.
  • Ensure billing information is accurate, complete, and supported by appropriate documentation prior to submission.
  • Review authorizations, service records, schedules, timesheets, EVV data, and related documentation to support accurate billing.
  • Post payments, adjustments, denials, and other account activity accurately and timely.
  • Reconcile billed services, payments received, outstanding balances, and payer remittance information.
  • Identify billing discrepancies and work with appropriate internal staff to resolve issues.
  • Monitor aging accounts and follow up on unpaid or denied claims.
  • Communicate with payers, managed care plans, insurance representatives, and other parties regarding claim status, payment issues, and billing corrections.
  • Assist with resolving claim denials, rejections, underpayments, and outstanding balances.
  • Maintain accurate billing records and documentation in accordance with agency policy, payer requirements, and applicable regulatory standards.
  • Protect confidential client and agency information in compliance with HIPAA and agency privacy practices.
  • Stay informed of billing requirements, payer updates, and process changes that may impact claims submission or reimbursement.
  • Work closely with scheduling, intake, payroll, compliance, and clinical staff to address billing-related questions or documentation needs.
  • Communicate clearly and professionally regarding billing issues, missing information, authorizations, and claim corrections.

Requirements


  • Prior experience in healthcare billing, home care billing, Medicaid Managed Care billing, or medical claims processing preferred.
  • Experience with LHCSA, home care, or long-term care billing is strongly preferred.
  • Knowledge of Medicaid, managed care plans, authorizations, EVV, and payer billing requirements preferred.
  • Experience with HHAeXchange, eMedNY, managed care portals, or similar billing systems preferred.
  • Strong attention to detail and ability to identify discrepancies in documentation, schedules, authorizations, and claims.
  • Ability to manage multiple priorities, meet deadlines, and maintain organized records.
  • Strong written and verbal communication skills.
  • Proficiency with Microsoft Office, especially Excel and Outlook.
  • High school diploma or equivalent required.
  • Associate degree or additional healthcare billing training preferred.


Angels In Your Home is an Equal Opportunity Employer and does not discriminate based on race, color, religion, sex, age, national origin, disability, veteran status, or any other protected status under federal, state, or local law.

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