ZipRecruiter

Log In

1

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

Reliance Standard

Claims Assistant SSL

Canandaigua, NY · On-site

$17.68 - $21.87/hr

Claims Assistant The Claims Assistant is an administrative support position within the Standard ... A choice of three medical plans (that include prescription drug coverage) to suit your unique needs.

Progressive

Auto Damage Claims Adjuster

Rochester, NY

$67K - $81K/yr

Negotiate repair process with body shops * Document information related to the claim and make ... Medical, dental & vision, including free preventative care * Wellness & mental health programs

Reliance Matrix

Claims Assistant SSL

Canandaigua, NY · On-site

$17.68 - $21.87/hr

Job Responsibilities and Requirements The Claims Assistant is an administrative support position ... A choice of three medical plans (that include prescription drug coverage) to suit your unique needs.

Rsli

Claims Assistant SSL

Canandaigua, NY · Hybrid

$17.68 - $21.87/hr

Job Responsibilities and Requirements The Claims Assistant is an administrative support position ... A choice of three medical plans (that include prescription drug coverage) to suit your unique needs.

previous pagenext page

Showing results 21-40

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 18, 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.
More about Medical Claims Processor jobs

What are the most commonly searched types of Medical Claims Processor jobs in Rochester, NY?

The most popular types of Medical Claims Processor jobs in Rochester, NY are:

What are popular job titles related to Medical Claims Processor jobs in Rochester, NY?

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

What job categories do people searching Medical Claims Processor jobs in Rochester, NY look for?

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 Management Specialist (Personal Injury Protection)

Erie Insurance

Rochester, NY • On-site

$52K - $84K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 10 days ago

Erie Insurance Group rating

8.8

Company rating: 8.8 out of 10

Based on 84 frontline employees who took The Breakroom Quiz

57th of 309 rated insurance

Job description

Division or Field Office:
Casualty Claims Division
Department of Position: Medical Management Department
Work from:
the Rochester, NY, Erie, Pittsburgh or Allentown Branch Office
Salary Range:
$52,843.00-$84,410.00*
salary range is for thislevel and may vary based on actual level of role hired for
*This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location (State) based on ERIE's geographical differences, and experience of an applicant, as well as level of role for which the successful candidate is hired. Position may be eligible for an annual bonus payment.
At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a diverse and inclusive team that includes more than 6,000 employees and over 13,000 independent agencies. Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia.
Benefits That Go Beyond The Basics
We strive to be Above all in Service® to our customers-and to our employees. That's why Erie Insurance offers you an exceptional benefits package, including:
  • Premier health, prescription, dental, and vision benefits for you and your dependents.Coverage begins your first day of work.
  • Low contributions to medical and prescription premiums.We currently pay up to 97% of employees' monthly premium costs.
  • Pension.We are one of only 13 Fortune 500 companies to offer a traditional pension plan. Full-time employees are vested after five years of service.
  • 401(k) with up to 4% contribution match.The 401(k) is offered in addition to the pension.
  • Paid time off.Paid vacation, personal days, sick days, bereavement days and parental leave.
  • Career development.Including a tuition reimbursement program for higher education and industry designations.
Additional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year.
Position Summary
Within designated authority, handles medical management claims with limited supervision.
*This role is being reposted adding language about the skills required. If you have applied, you will NOT need to reapply, your application is under consideration.
  • Multiple positions are available.
  • The successful candidate should have experience with personal injury protection.
  • The successful candidate will work from one of the following branches: Rochester, NY, Erie, Pittsburgh or Allentown Branch office.
Duties and Responsibilities
  • Handles first party medical benefit claims, including fatalities and wage loss claims. Evaluates and makes decisions regarding coverage. Conducts investigations, determines total value of claims, sets and maintains adequate reserves, and manages cases.
  • Prepares related correspondence and reports, obtains medical and employment related records, calculates wage loss claims per applicable state laws and brings claims to conclusion.
  • Investigates, evaluates, and resolves coverage questions in compliance with applicable state laws.
  • Establishes immediate contact with Policyholders and Claimants. Contacts Agents as necessary.
  • Reviews claim files on a regular basis and takes necessary follow-up and/or closing action.
  • Evaluates, processes and takes appropriate action on claim-related bills and medical, rehabilitation and special investigative reports. Determines claims to be paid, compromised or contested.
  • Coordinates activities with the Home Office on serious or massive injury cases. Notifies company investigative services of cases involving suspected fraud.
  • When appropriate manages claims in litigation and assist in the development of case strategy with legal counsel.
Duties and Responsibilities (cont'd if applicable)
  • Attends industry-related training programs to stay current on legal developments and ensure compliance with applicable laws and regulations impacting the operation of the department.
  • Assists or acts on the behalf of supervisor when required, including handling of insurance department complaints.
  • When appropriate identifies subrogation situations and initiates appropriate action.
  • Develops expertise in legal and medical terminology and procedures.
  • Assists in training branch office personnel in related matters.
  • Assigns, monitors and controls activities of vendors in a cost-effective manner.
The first five duties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished.
This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job-related instruction and to perform any other duties as requested by their supervisor, or as become evident.
Capabilities
  • Values Diversity
  • Job-Specific Knowledge
  • Self-Development
  • Nimble Learning
  • Collaborates
  • Customer Focus
  • Cultivates Innovation
  • Optimizes Work Processes (IC)
  • Instills Trust
  • Ensures Accountability
  • Decision Quality
Qualifications
Minimum Educational Requirements
  • High School Diploma or GED and two years of general claims handling experience required, or;
  • Bachelor's Degree required.
  • OR completion of formal ERIE training program, required.
Additional Experience
  • Strong working knowledge of applicable state laws preferred.
  • Good working knowledge of human anatomy and medical terminology preferred.
  • Expertise in state no-fault laws and working knowledge of civil law preferred.
  • Working knowledge of medical bill repricing system preferred.
Designations and/or Licenses
  • Successful completion of AIC courses preferred.
  • Appropriate license as required by state.
Physical Requirements
  • Lifting/Moving 0-20 lbs; Occasional (<20>
  • Lifting/Moving 20-50 lbs; Occasional (<20>
  • Ability to move over 50 lbs using lifting aide equipment; Occasional (<20>
  • Driving; Rarely
  • Pushing/Pulling/moving objects, equipment with wheels; Occasional (<20>
  • Manual Keying/Data Entry/inputting information/computer use; Often (20-50%)
  • Climbing/accessing heights; Rarely

Nearest Major Market: Rochester

What Erie Insurance Group employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply