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Medical Claims Rep Jobs (NOW HIRING)

Brown & Brown

Senior Claims Representative

Carmel, IN · On-site

Senior Claims Representative Built on meritocracy, our unique company culture rewards self-starters ... Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance * Financial Benefits: ESPP; 401k;

Cabot Risk Strategies

Claims Representative

Woburn, MA · On-site

Claim Representative Responsible for all phases of assigned claims handling. Involved from taking ... Obtains information from witnesses, police, or doctors, etc., and secures medical bills or any ...

Tanner Clinic

Medical Claims Assistant

Kaysville, UT · On-site

Monday - Friday Essential Job Responsibilities: * Assist Senior Rep in resolving insurance claims ... Knowledge of basic medical terminology, after training Skills: * Using logic and reasoning to ...

EMC

Claims Representative

$51K - $71K/yr

As a Claims Representative, you'll play a key role in helping clients navigate the claims process ... Secure and review medical records, bills, invoices, receipts, and other supporting documentation ...

Cabot Risk Strategies Llc

Claims Representative

Woburn, MA · On-site

$60K - $70K/yr

CLAIM REPRESENTATIVE Purpose and Description Responsible for all phases of assigned claims handling ... Obtains information from witnesses, police, or doctors, etc., and secures medical bills or any ...

Tanner Clinic

Medical Claims Assistant

Kaysville, UT · On-site

Monday - Friday Essential Job Responsibilities: * Assist Senior Rep in resolving insurance claims ... Knowledge of basic medical terminology, after training Skills: * Using logic and reasoning to ...

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Medical Claims Rep information

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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

Senior Claims Representative

Carmel, IN • On-site

Brown & Brown
Law Firms • 11 - 50 employees
Learn more about Brown & Brownexternal

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 6 days ago

Job description

Senior Claims Representative

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.

Brown & Brown is seeking a Senior Claims Representative to join our growing team in Carmel, IN!

The Senior Claims Representative manages high priority accounts and catastrophic claims.

How You Will Contribute:

  • Maintain a claim inventory as deemed appropriate by management
  • Verify, research evaluate and make recommendations on appropriate coverage on each claim, using discretionary judgment
  • Make timely contact with members, injured workers, agents, providers, attorneys, etc.
  • Investigate claim with phone interviews/emails and obtain appropriate documentation
  • Evaluate exposure and adjust reserves as required
  • Conclude claim processing in accordance with company standards
  • Meet with members, agents, injured workers, attorneys, etc. as deemed necessary
  • Provide training and act as a mentor for members and other claims personnel
  • Travel to annual workers compensation conference and/or attend educational seminars
  • Other job-related projects or assignments as delegated
  • The Sr. Claims Representative will maintain and uphold a high standard for customer service.

Licenses and Certifications:

  • Insurance and/or Industry certification or designation

Skills & Experience to Be Successful:

  • Associate's or Bachelor's degree in business, financial related discipline, or Human Resources (preferred)
  • Proficient with Microsoft, Windows, Excel, IVOS, etc.
  • Exceptional telephone demeanor
  • Ability to maintain a high level of confidentiality
  • 3 – 5 years' experience in similar position

Teammate Benefits & Total Well-Being

We go beyond standard benefits, focusing on the total well-being of our teammates, including:

  • Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
  • Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
  • Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services
  • Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.

Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.

The Power To Be Yourself

As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, "The Power to Be Yourself".

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