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Medical Claims Jobs (NOW HIRING)

Moda Health

Medical Claims Entry Operator

Milwaukie, OR

$17.34 - $18.92/hr

Reassigns claims appropriately as outlined by Medical Claims processing guidelines. * Resolves claims that pend with errors in the processing system by matching claims received to Moda providers or ...

New

Trident

Medical Claims Examiner

$30/hr

In this role, you will be responsible for the accurate and timely processing of self-funded medical health insurance claims. Because this is a fully remote, independent contractor position, we are ...

CNSCares

Medical Claims Specialist

Overland Park, KS

$20 - $24/hr

... medical records as necessary. * Help claimants file initial claims and refile claims that have been denied. * Inform individuals of the resources available that may assist their claim process and ...

RemX

Be Seen First

$19/Hr. Remote Medical Claims Rep.

Las Vegas, NV · Remote

$19/hr

Medical Claims Rep * Pay: $19/hr. Weekly Pay plus Benefits * Paid Training!!! * Equipment will be shipped to you! * Schedule: 8am-9pm EST. M-Fri. (Must be able to work ANY 8hr Shift between these ...

Amwins

Medical Claims Manager

Peoria, AZ · Hybrid

Claims Manager -- Amwins Self-Funded Are you ready to make a meaningful impact in a collaborative, people-focused environment? Amwins Self-Funded is looking for a Claims Manager to lead and support a ...

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Medical Claims information

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$5

$16

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How much do medical claims jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for medical claims in the United States is $16.83, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $18.27 per hour, depending on experience, location, and employer.

What are medical claims?

Medical claims are formal requests submitted by healthcare providers or patients to insurance companies, asking for payment for medical services rendered. These claims contain detailed information about the patient, the services provided, dates of service, and relevant medical codes. Insurance companies review the claims to determine coverage and reimburse providers or patients accordingly. Accurate and timely submission of medical claims is crucial to ensure proper payment and avoid delays or denials.

How to become a medical claims examiner?

To become a medical claims examiner, candidates typically need a high school diploma or equivalent, with some roles requiring postsecondary education or certification in health insurance or medical billing. Relevant skills include attention to detail, knowledge of medical terminology, and familiarity with claims processing software; certifications such as the Certified Medical Claims Examiner (CMCE) can enhance job prospects.

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

To thrive as a Medical Claims Specialist, you need knowledge of medical terminology, insurance policies, and claims processing, typically supported by a high school diploma or relevant certification. Familiarity with claims management software, electronic health records (EHRs), and billing systems such as ICD-10 and CPT coding is essential. Attention to detail, strong organizational skills, and effective communication help ensure accuracy and resolve claim discrepancies. These skills are crucial for ensuring timely and accurate claims processing, minimizing errors, and maintaining compliance with healthcare regulations.

What are some common challenges faced in a medical claims role, and how can they be effectively managed?

Medical claims professionals often encounter challenges such as handling denied or complex claims, navigating frequent regulatory changes, and communicating with both patients and insurance providers. Staying updated with the latest healthcare regulations and payer requirements is essential to minimize claim rejections. Effective time management, attention to detail, and strong communication skills help resolve issues quickly and ensure accurate processing. Collaborating closely with billing teams and healthcare providers also aids in addressing discrepancies and expediting claim approvals.

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

AspectMedical ClaimsMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies and coding; certifications like CPC or CCS are commonRequires similar certifications; focuses on billing processes and insurance claims
Work EnvironmentHealthcare facilities, insurance companies, billing companiesMedical offices, hospitals, billing companies
Job FocusSubmitting and managing insurance claims for reimbursementPreparing and sending bills to patients and insurers, managing accounts

Medical Claims specialists primarily handle the submission and management of insurance claims to ensure healthcare providers receive payment. Medical Billing Specialists focus on creating and sending bills to patients and insurance companies, managing payments, and maintaining billing records. While both roles require knowledge of insurance processes and coding, Medical Claims roles are more centered on claims submission and follow-up, whereas Medical Billing Specialists handle the overall billing process and patient invoicing.

Is medical claims processing a stressful job?

Medical claims processing can be stressful due to tight deadlines, high accuracy requirements, and the need to handle complex or disputed claims. The job often involves detailed data entry, familiarity with insurance policies, and sometimes dealing with frustrated clients, which can contribute to stress levels. However, workload and stress vary depending on the employer and individual workload management skills.
More about Medical Claims jobs
What cities are hiring for Medical Claims jobs? Cities with the most Medical Claims job openings:
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Medical Claims jobs near you
Infographic showing various Medical Claims 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 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $35,000 per year, or $16.8 per hour.

Medical Claims Auditor (Hybrid)

Northwest Administrators, Inc.

Federal Way, WA • Hybrid

$30.70 - $41.54/hr

Full-time

Re-posted 3 hours ago

Job description

Are you a skilled communicator with strong writing abilities and deep claims experience? Do you have actual hands-on experience processing medical claims, from beginning to end? Do you enjoy applying your medical claims expertise to work one-on-one, or in small group settings, to help others strengthen their accuracy, compliance, and performance? If you answered 'YES' to these questions, then you may be the person we're seeking for our Claims Auditor position!

What you'll be doing...

As a Health and Welfare Claims Auditor, the main focus will be to review the work completed by the Health and Welfare Medical, Dental, Vision, Time Loss and Life Claims Processors. This position requires collaboration with other auditors, outside vendors, account executives, department supervisors and managers, and medical consultants.

Primary responsibilities for this position include:

  • Perform internal audits of our Health and Welfare Claims Processors' work
  • Design and implement training plans for Claims Processors
  • Conduct training sessions for groups of new Claims Processors
  • Train and cross-train on plan, system and procedural changes
  • Respond to day-to-day referral questions
  • Perform random and large dollar claims audits
  • Prepare written claim processing guideline materials
  • Coordinate vendor interaction with specific PPOs and benefit providers

This position has a hybrid work schedule with 3 days per week in the office, after completion of training. The position can be based in our Seattle, Mountlake Terrace or Federal Way office.

Who you are...

  • Educated. Bachelor's degree preferred or equivalent combination of education & experience
  • Experienced. Medical & Dental Claims processing; auditing/training experience preferred
  • Organized. Able to prioritize work, multi-task and work independently
  • Communicator. Excellent verbal, written and interpersonal communication skills
  • Technically Savvy. Intermediate level experience using Microsoft Office Suite of tools

Who we are…

Northwest Administrators, Inc. is an industry leader in third-party administration of employee benefits. We administer one of the largest multi-employer pension plans in the country, along with numerous large health and welfare plans. As part of our team, you will benefit from many training and development opportunities and can expect a better-than-market benefits package. See what our associates are saying about us at Northwest Administrators Inc. | Careers (nwadmin.com)

If hired, you can expect...

  • Hourly rate range of $30.70 - $41.54 per hour (dependent upon experience & qualifications)
  • Medical, dental (w/Orthodontia), vision, Rx benefits, disability & life insurance
  • Optional benefits: health flex spending, dependent care assistance & pet insurance
  • Generous 401(k) plan with employer base contribution and match
  • Paid Vacation (10 days), Sick Leave (10 days) and Holidays (10 days)
  • Collaborative team environment
  • Work-life balance

Equal Employment Opportunity

NWA is proud to be an Equal Employment Opportunity employer. All employment decisions are based on business needs, job requirements and individual qualifications, without regard to race, color, religion, national origin, sex, sexual orientation, gender identity or expression, age, physical or mental disability, marital status, amnesty, veteran status, citizenship, family medical history or genetic information or any other characteristic protected by local, state, or federal laws. NWA prohibits any discrimination or harassment based on any of these characteristics.

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact Human Resources at HR@nwadmin.com to request accommodation.

Northwest Administrators Inc. | Privacy Policy (nwadmin.com)