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Medical Claims Reviewer Jobs (NOW HIRING)

Datamark, Inc.

Medical Claims Processor

El Paso, TX · On-site

$16.50/hr

Team as a Medical Claims Processor! Are you looking for an exciting opportunity where your ... Pull and review customer accounts to assess eligibility, benefits, and coverage limitations

Tanner Clinic

Medical Claims Assistant

Kaysville, UT · On-site

Review denied claims and sort into proper category for resolution * Other duties as assigned ... Knowledge of basic medical terminology, after training Skills: * Using logic and reasoning to ...

Insperity

Medical Claims Examiner

CA · Remote

$24 - $30/hr

Description & Requirements Medical Claims Examiner- Chatsworth Local Remote or In-Office Join a ... review and analysis involving NCCI rules. * Extensive working knowledge of reimbursement ...

Company Name Withheld

Be Seen First

Medical Claims Examiner-Entry Level

Kalamazoo, MI · On-site

Responsibilities · Review and process medical claims · Research claim, benefit, eligibility, and payment questions · Communicate with medical providers and plan members by phone · Review EOBs ...

Insperity

Medical Claims Examiner

Los Angeles, CA · On-site +1

$24 - $30/hr

General information Client / Corporate Client Work Mode Hybrid Name Medical Claims Examiner Job ID ... review and analysis involving NCCI rules. * Extensive working knowledge of reimbursement ...

Adecco

Medical Claims Examiner

San Antonio, TX

$22.50/hr

Review, analyze, and adjudicate medical claims for accuracy and compliance * Ensure claims are processed accurately and within required timelines * Investigate and resolve provider inquiries and ...

ttg Talent Solutions

Medical Claims Processor

Doral, FL · On-site

$22 - $23/hr

Medical Claims Processor Location: Doral, FL on-site Schedule: Full-Time | 40 hours per week ... Review, adjudicate, and reprocess Medicare and DSNP claims accurately. * Handle disputes ...

NTT Data Americas, Inc.

Medical Claims Processor

$17 - $18/hr

Reviewing the policies and benefits • Comply with company regulations regarding HIPAA ... s) of Medical Claims experience * 2+ year(s) using a computer with Windows applications that ...

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Medical Claims Reviewer information

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How much do medical claims reviewer jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for medical claims reviewer 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 reviewer?

Medical claims reviewers are professionals who evaluate health insurance claims to determine their accuracy, validity, and compliance with policy guidelines. They review medical records, billing codes, and documentation to ensure that services billed by healthcare providers are medically necessary and covered by the patient's insurance plan. Their work helps prevent fraud, reduce errors, and ensure that insurance companies only pay for appropriate medical expenses. Medical claims reviewers play a crucial role in the healthcare reimbursement process, working for insurance companies, third-party administrators, or healthcare providers.

What are the key skills and qualifications needed to thrive as a medical claims reviewer, and why are they important?

To thrive as a Medical Claims Reviewer, you need a solid understanding of medical terminology, coding systems (such as ICD-10 and CPT), and insurance policies, often supported by a background in healthcare administration or medical billing. Familiarity with claims processing software, electronic health records (EHR), and sometimes certification as a Certified Professional Coder (CPC) is valuable. Attention to detail, analytical thinking, and strong written communication help reviewers accurately assess claims and document findings. These skills ensure precise claim evaluations, minimize errors, and support fair, timely reimbursement decisions.

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

Medical Claims Reviewers often encounter challenges such as interpreting complex medical documentation, ensuring compliance with ever-changing healthcare regulations, and managing tight deadlines. Staying current with policy updates and medical coding changes is essential for accuracy. Effective time management, attention to detail, and ongoing training can help reviewers handle workloads efficiently while minimizing errors. Collaborating with colleagues in billing, coding, and clinical teams also aids in resolving discrepancies and ensuring claims are processed correctly.

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

AspectMedical Claims ReviewerMedical Billing Specialist
CredentialsTypically requires insurance or healthcare certifications, such as CPC or CCSOften requires billing or coding certifications, like CPC or CPC-A
Work EnvironmentHealthcare insurance companies, third-party administrators, or healthcare providersMedical offices, hospitals, or billing companies
Job FocusReviewing and validating insurance claims for accuracy and compliancePreparing and submitting medical bills to insurance companies and patients

The Medical Claims Reviewer and Medical Billing Specialist roles share overlapping skills in healthcare documentation and insurance processes. However, the Claims Reviewer primarily focuses on evaluating and validating claims for accuracy, while the Billing Specialist handles the creation and submission of bills. Both roles are essential in the healthcare revenue cycle and often work closely within healthcare organizations.

More about Medical Claims Reviewer jobs

What states have the most Medical Claims Reviewer jobs?

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

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

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

Medical Claims Reviewer jobs near you
Infographic showing various Medical Claims Reviewer job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $43,428 per year, or $20.9 per hour.

Medical Claims Assistant

Kaysville, UT • On-site

Tanner Memorial Clinic
See more jobs at Tanner Memorial Clinicexternal

Full-time

Posted 21 days ago

Job description

Description:

Tanner Clinic has an immediate opening for a Medical Claims Assistant.


Location: Kaysville Business Office

Hours: Monday - Friday


Essential Job Responsibilities:

  • Assist Senior Rep in resolving insurance claims issues including claims that are paid incorrectly or unpaid.
  • Review denied claims and sort into proper category for resolution
  • Other duties as assigned


Requirements:

Education:

  • High School diploma 

Experience:

  • Related work experience preferred, not required

Other Requirements:

  • Basic computer knowledge & internet proficient and keyboarding proficiency, required
  • Regular and reliable attendance is an essential function of the job, required
  • General knowledge of insurance terms and claim processing, preferred.

Performance Requirements:

Knowledge:

  • Knowledge of CPT, HCPCS and ICD-9, ICD-10 and other coding values, after training
  • Knowledge of basic medical terminology, after training

Skills:

  • Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems

Abilities:

  • The ability to apply general rules to specific problems to produce answers that make sense

Equipment Operated:

  • Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.     

Work Environment:

  • Position is in a well-lighted office environment. 

Mental/Physical Requirements: 

  • Involves sitting approximately 90 percent of the day, walking or standing the remainder.