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Medical Claims Representative Trainee Jobs in Rochester, NY

Progressive

Claims Adjuster Trainee

Rochester, NY · Hybrid

$60.50K - $63K/yr

As a claims adjuster trainee , you'll learn how to help customers get back on the road after an ... Medical, dental & vision, including free preventative care * Wellness & mental health programs

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Medical Claims Representative Trainee information

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How much do medical claims representative trainee jobs pay per hour?

As of May 28, 2026, the average hourly pay for medical claims representative trainee in Rochester, NY is $20.61, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $22.79 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Medical Claims Representative Trainee, and why are they important?

To thrive as a Medical Claims Representative Trainee, you need a strong understanding of medical terminology, attention to detail, and at least a high school diploma or equivalent. Familiarity with claims management software, healthcare billing systems, and possibly industry certifications like those from AAPC or AHIMA are valuable. Excellent communication, problem-solving, and organizational skills help you navigate complex cases and interact effectively with claimants and providers. These competencies are crucial for accurately processing claims, minimizing errors, and ensuring customer satisfaction in a regulated healthcare environment.

What are some common challenges faced by Medical Claims Representative Trainees during their initial training period?

Medical Claims Representative Trainees often encounter challenges such as learning complex insurance policies and procedures, understanding medical terminology, and mastering multiple claims processing systems. Adapting to the fast-paced environment and balancing accuracy with efficiency can also be demanding. However, most organizations provide comprehensive training, mentorship, and ongoing support to help trainees build confidence and competence in these areas.

What does a Medical Claims Representative Trainee do?

A Medical Claims Representative Trainee assists in reviewing, processing, and resolving medical insurance claims. They learn how to evaluate claims for accuracy, determine coverage eligibility, and communicate with policyholders, healthcare providers, and other parties. The trainee works under supervision, gaining knowledge of company policies, claims procedures, and medical terminology. Over time, they develop the skills needed to handle claims independently and ensure compliance with legal and regulatory guidelines.

What is the difference between Medical Claims Representative Trainee vs Medical Claims Representative?

AspectMedical Claims Representative TraineeMedical Claims Representative
CredentialsHigh school diploma or equivalent; on-the-job trainingHigh school diploma; certification or licensing may be preferred
Work EnvironmentTraining environment, supervised tasksFull-time office or remote work, handling claims independently
Job ResponsibilitiesAssisting with claims processing, learning proceduresProcessing claims, reviewing documentation, resolving issues

The Medical Claims Representative Trainee role is an entry-level position focused on training and gaining experience, while the Medical Claims Representative handles claims independently with more responsibility. Trainees develop skills before advancing to full representative roles.

What are popular job titles related to Medical Claims Representative Trainee jobs in Rochester, NY? For Medical Claims Representative Trainee jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Medical Claims Representative Trainee jobs in Rochester, NY look for? The top searched job categories for Medical Claims Representative Trainee jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Medical Claims Representative Trainee jobs? Cities near Rochester, NY with the most Medical Claims Representative Trainee job openings:
Medical Claims Representative Trainee jobs near you
Infographic showing various Medical Claims Representative Trainee job openings in Rochester, NY as of May 2026, with employment types broken down into 66% Full Time, 14% Part Time, 1% Temporary, and 19% Contract. Highlights an 99% Physical, and 1% Hybrid job distribution, with an average salary of $42,868 per year, or $20.6 per hour.
Clm Resltion Rep III, Hosp/Prv

Clm Resltion Rep III, Hosp/Prv

University of Rochester

Rochester, NY • On-site

$19.62 - $26.49/hr

Full-time

Posted 19 days ago

University Of Rochester rating

8.3

Company rating: 8.3 out of 10

Based on 178 frontline employees who took The Breakroom Quiz

92nd of 528 rated colleges and universities

Job description

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.
Job Location (Full Address):
Remote Work - New York, Albany, New York, United States of America, 12224
Opening:
Worker Subtype:
Regular
Time Type:
Full time
Scheduled Weekly Hours:
40
Department:
910402 United Business Office
Work Shift:
UR - Day (United States of America)
Range:
UR URC 205 H
Compensation Range:
$19.62 - $26.49
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
Responsibilities:
GENERAL PURPOSE
The Claims Resolution Representative III is responsible for working across the professional fee organization, handling follow-up activities designed to bring all open accounts receivable to successful closure. Responsible for effective claims follow-up on complex, multi-faceted accounts to obtain maximum revenue collection and closure. Responsibilities include, but are not limited to, independent research, claim correction and resubmission, handling payer specific appeal process taking timely and routine action to resolve unpaid claims. The Claims Resolution Representative III reports to Accounts Receivable Management.
ESSENTIAL FUNCTIONS
With general direction of the Manager/Supervisor/Lead:
40% Follows department policies and procedures and maintains and exercises comprehensive knowledge of insurance company billing requirements and regulations to research and resolve unpaid accounts receivable, making any corrections in the professional billing system necessary to ensure balance resolution for all assigned URMFG physician services.
25% Follows up on multi-faceted denials through review of remittances (EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc.
  • Research claims, identify problems, and take appropriate action to assure claim resolution.

20% Responds to all billing-related inquiries from colleagues, departments, patients, and payors in a timely and professional manner.
  • Communicates any missing/incomplete information to providers and department administrative support staff to ensure accurate billing.
  • Communicates with insurance representatives through telephone calls, payer website, and written communication to ensure accurate processing of claims.
  • Collaborate with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies.

10% Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding.
  • Escalates system issues preventing claims submission and follow-up for review and resolution.

5% Collaborates with Claim Edit Specialists and Patient Medical Billing Specialists assigned to pre claim WQ's to identify opportunities for improvement in clean claims rate.
May perform other duties as assigned.
QUALIFICATIONS
Required:
  • Associate degree and 2 years of related relevant experience; or equivalent combination of education and/or experience
  • Excellent problem-solving skills
  • Excellent communication skills
  • Excellent customer service skills

Preferred:
  • Strong working knowledge of the professional billing software applications
  • Ability to type 25 wpm.

The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University's Mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.

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