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Medical Claims Processor Jobs in Scranton, PA (NOW HIRING)

OneSource

Medical Biller

Wilkes Barre, PA

$15.75/hr

Keywords & Skills Medical Billing Specialist, Accounts Receivable Representative, Healthcare AR, Revenue Cycle, Payment Posting, Claims Processing, Denials Management, EOB, ERA, EFT, ICD-9, CPT ...

CNA

Commercial Auto Claims Representative

Kingston, PA · On-site

Commercial Claims Management You have a clear vision of where your career can go. And we have the ... CNA utilizes AI-enabled technology during the recruiting process. For more information, please ...

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All JobsMedical Claims Processor JobsMedical Claims Processor Jobs in Scranton, PA

Medical Claims Processor information

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$13

$19

$25

How much do medical claims processor jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for medical claims processor in Scranton, PA is $19.27, according to ZipRecruiter salary data. Most workers in this role earn between $17.12 and $21.39 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

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For Medical Claims Processor jobs in Scranton, PA, the most frequently searched job titles are:

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Cities near Scranton, PA with the most Medical Claims Processor job openings:

Medical Claims Processor jobs near you
Infographic showing various Medical Claims Processor job openings in Scranton, PA as of August 2026, with employment types broken down into 60% Full Time, 20% Temporary, and 20% Contract. Highlights an 68% In-person, 16% Hybrid, and 16% Remote job distribution, with an average salary of $40,083 per year, or $19.3 per hour.

Claims Representative - Medical Only

Berkshire Hathaway GUARD Insurance Companies

Wilkes Barre, PA • Hybrid

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 10 days ago

Job description

Overview

Good Things Start Here.

Good things are happening at Berkshire Hathaway GUARD Insurance Companies-an A+ (Superior) rated, nationwide Property & Casualty insurer backed by Berkshire Hathaway. With supportive leadership, collaborative teams, and opportunities to grow, GUARD is a place where people build meaningful, longterm careers.

Good Things You Can Count On.

  • Hybrid schedule: 2 days remote / 3 inoffice
  • Predictable hours (no nights, weekends, or holidays)
  • Competitive pay + generous PTO
  • Medical, dental & vision starting day one
  • 401(k), tuition reimbursement & longevity bonuses
Responsibilities

We are seeking a Medical Claims Representative in our Wilkes-Barre, PA office to manage Workers' Compensation medical-only claims while providing timely service to injured workers, employers, and medical providers. This role is responsible for the communication, coordination and administration of Workers' Compensation claims.

  • Manage Workers' Compensation medical-only claims from initial report through resolution.
  • Determine compensability and ensure timely delivery of benefits.
  • Coordinate medical treatment and facilitate early return-to-work efforts.
  • Review and process medical bills for payment.
  • Serve as a liaison between injured workers, employers, and medical providers.
  • Provide guidance regarding Workers' Compensation processes and claim management.
  • Maintain accurate claim documentation and comply with applicable regulations and company procedures.
Qualifications

Candidate must have:

  • Proficiency with Microsoft Office applications and other business technologies
  • Strong communication, organizational, and customer service skills
  • Ability to understand and apply medical and legal terminology related to Workers' Compensation claims
  • Strong attention to detail
  • Ability to learn new technology and systems
  • High School Diploma/GED required; additional education or relevant claims experience is a plus
  • Licensing Requirement: Candidates must hold an active adjuster license or be willing and able to obtain and maintain all required state licenses. The company will support the licensing process, including cost, training and compliance with ongoing continuing education requirements

Interview Integrity Notice: Berkshire Hathaway GUARD is committed to a fair and consistent hiring process. Candidates are expected to participate independently in interviews. Unauthorized recording, transcription, AI note-taking, or AI interview assistance tools may not be used during interviews without prior approval.

Employment Type: FULL_TIME

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