ZipRecruiter

Log In

1

Medical Claims Rep Jobs (NOW HIRING)

NTT DATA

Remote Medical Claims Representative

Plano, TX · Remote

$18/hr

Remote Medical Claims Representative At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in ...

NTT DATA

Remote Medical Claims Representative

Plano, TX · Remote

$18/hr

Remote Medical Claims Representative At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in ...

RemX

Be Seen First

Remote Medical Claims Specialist | $19/hr

Tampa, FL · Remote

$19/hr

Remote Medical Claims Rep| $19/hr. Weekly Pay & Benefits | Equipment Provided | Start Date: October 2026 | Mon-Fri, Any 8-Hour Shift Between 8 AM-9PM CST Why Join? * Pay - $19/hr. + Weekly Pay ...

Cottingham & Butler

Claims Examiner

Dubuque, IA · On-site

Medical Claims Representative SISCO, a Cottingham & Butler company, is continuing to grow and as a result will be adding Medical Claims Representatives to our team! This position is responsible for ...

Cottingham & Butler

Claims Examiner

Dubuque, IA · On-site

Medical Claims Representative SISCO, a Cottingham & Butler company, is continuing to grow and as a result will be adding Medical Claims Representatives to our team! This position is responsible for ...

Cottingham & Butler

Claims Examiner

Dubuque, IA

Medical Claims Representative SISCO, a Cottingham & Butler company, is continuing to grow and as a result will be adding Medical Claims Representatives to our team! This position is responsible for ...

SISCO

Claims Examiner

Dubuque, IA · On-site

Medical Claims Representative SISCO, a Cottingham & Butler company, is continuing to grow and as a result will be adding Medical Claims Representatives to our team! This position is responsible for ...

Addison Group

Claims Representative

Austin, TX · On-site

$21/hr

This position is eligible for Medical, Dental, Vision, & 401K Addison Group is partnering with a growing insurance administration organization to identify a detail-oriented Claims Representative to ...

EquipmentShare

Claims Representative

Saint Louis, MO · On-site

Future Claims Representative Opportunities at EquipmentShare! EquipmentShare is accepting ... Full medical, dental, and vision coverage for full-time employees * Generous PTO + paid holidays ...

EquipmentShare

Claims Representative

Saint Louis, MO · On-site

Future Claims Representative Opportunities at EquipmentShare! EquipmentShare is accepting ... Full medical, dental, and vision coverage for full-time employees * Generous PTO + paid holidays ...

next page

Showing results 1-20

All JobsFinance And Insurance JobsInsurance JobsInsurance Claims Specialist JobsMedical Claims Rep Jobs

Medical Claims Rep information

See salary details

$13

$20

$29

How much do medical claims rep jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for medical claims rep in the United States is $20.88, according to ZipRecruiter salary data. Most workers in this role earn between $17.79 and $23.08 per hour, depending on experience, location, and employer.

What is a medical claims rep?

Medical Claims Representatives, also known as Medical Claims Processors or Examiners, are professionals who review, process, and adjudicate healthcare insurance claims submitted by patients or healthcare providers. They evaluate medical documentation, verify insurance coverage, determine payment eligibility, and ensure claims comply with policy guidelines. Their work is essential in ensuring that valid claims are paid out correctly and that any discrepancies or errors are investigated and resolved.

What are the key skills and qualifications needed to thrive as a medical claims rep?

To thrive as a Medical Claims Representative, you need a solid understanding of healthcare billing, insurance claims processes, and medical terminology, often supported by a high school diploma or associate degree. Familiarity with claims management software, electronic health record (EHR) systems, and coding systems like ICD-10 and CPT is typically required. Strong attention to detail, problem-solving skills, and effective communication help you manage complex claims and interact with patients and providers. These skills ensure accurate claim processing, minimize errors, and facilitate timely reimbursements in the healthcare system.

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

Medical Claims Representatives often face challenges such as handling high volumes of complex claims, navigating varying insurance policies, and ensuring timely communication with healthcare providers and patients. Staying organized, developing a strong understanding of medical terminology and insurance guidelines, and using claims management software can help manage these challenges. Regular training and support from experienced team members also play a crucial role in helping new representatives adapt and succeed in this fast-paced environment.

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

AspectMedical Claims RepMedical Billing Specialist
CredentialsHigh school diploma; certification often preferredHigh school diploma; certification often preferred
Work EnvironmentInsurance companies, healthcare providers, billing officesHealthcare facilities, billing companies, clinics
Job FocusReview and process insurance claims, ensure reimbursementPrepare and submit bills, manage patient accounts
Common TasksVerify insurance, resolve claim denialsGenerate invoices, follow up on payments

While both roles involve handling healthcare financial processes, Medical Claims Reps primarily focus on reviewing and processing insurance claims to secure reimbursement, whereas Medical Billing Specialists handle the creation and management of patient bills and payments. Both roles require similar certifications and work in healthcare or insurance settings, but their daily tasks and focus areas differ.

What states have the most Medical Claims Rep jobs?

States with the most job openings for Medical Claims Rep jobs include:

What are popular job titles related to Medical Claims Rep jobs?

For Medical Claims Rep jobs, the most frequently searched job titles are:

Medical Claims Rep jobs near you

Claims Representative - Medical Only

Beach Haven, PA • On-site

Berkshire Hathaway GUARD Insurance Companies
Insurance Services • 1 - 5K employees
Learn more about Berkshire Hathaway GUARD Insurance Companiesexternal

Other

Posted 27 days ago

Job description

Job Title

Medical Claims Representative

Job Description

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, long‑term careers.

Responsibilities

The Medical Claims Representative manages 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

Apply