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Medical Claims Representative Jobs (NOW HIRING)

RemX

Remote Medical Claims Rep| $19/hr

Dallas, TX · Remote

$17/hr

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

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 ...

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 ...

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 ...

Athene

Claims Representative

West Des Moines, IA · On-site

A Claims Representative at Athene is responsible for researching and processing claims requests ... Works with agents, agency personnel, claimants, beneficiaries, physicians, medical institutions ...

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Medical Claims Representative information

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How much do medical claims representative jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for medical claims representative 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 does a medical claims representative do?

A Medical Claims Representative is responsible for processing and reviewing insurance claims related to healthcare services. They evaluate medical documents, verify patient information, and ensure that claims are accurate and comply with insurance policies. Their job also includes communicating with healthcare providers, policyholders, and insurance adjusters to resolve discrepancies or gather additional information. Ultimately, they help ensure claims are paid correctly and in a timely manner.

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

To thrive as a Medical Claims Representative, you need strong knowledge of medical terminology, insurance policies, and claims processing, often backed by a high school diploma or associate degree in a related field. Familiarity with claims management software, ICD and CPT coding systems, and electronic health records is typically required. Attention to detail, problem-solving abilities, and effective communication skills are crucial soft skills for success. These skills and qualities are important because they ensure accurate claims processing, minimize errors, and provide excellent service to clients and healthcare providers.

What are some common challenges medical claims representatives face when handling complex claims?

Medical Claims Representatives often encounter challenges such as deciphering intricate medical documentation, ensuring compliance with ever-changing insurance regulations, and managing high volumes of claims with tight deadlines. They must carefully communicate with healthcare providers, policyholders, and other insurance professionals to resolve discrepancies or gather missing information. Staying organized, detail-oriented, and up-to-date on policy guidelines is key to overcoming these obstacles and ensuring accurate and timely claim processing.

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

AspectMedical Claims RepresentativeMedical Billing Specialist
CredentialsHigh school diploma; certification often preferredHigh school diploma; certification often preferred
Work EnvironmentInsurance companies, healthcare providers, third-party payersHealthcare facilities, billing companies, clinics
Job FocusProcessing and reviewing insurance claims for reimbursementPreparing and submitting billing statements to patients and insurers
Common UsageInsurance companies, healthcare providersMedical offices, billing services

While both roles involve handling healthcare financial transactions, Medical Claims Representatives primarily focus on processing insurance claims and ensuring proper reimbursement, whereas Medical Billing Specialists handle the creation and submission of billing statements to patients and insurers. Both roles require similar credentials and often work in healthcare or insurance settings, but their specific responsibilities differ.

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Medical Claims Representative jobs near you
Infographic showing various Medical Claims Representative job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $43,428 per year, or $20.9 per hour.

Claims Representative - Medical Only

Berkshire Hathaway GUARD Insurance Companies

Beach Haven, PA • On-site

Other

This job post has expired today. Applications are no longer accepted.

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