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Medical Insurance Claims Processor Jobs in Michigan

Healthrise

Clinical Denials Specialist

Farmington Hills, MI · On-site

$17.75 - $23.50/hr

Minimum of 2-3 years of experience in healthcare revenue cycle management, medical billing, claims processing, or denial management. Physical Demands and Work Environment * Work Environment: This job ...

Company Name Withheld

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Medical Claims Examiner-Entry Level

Kalamazoo, MI · On-site

... claims processing experience is not required. We provide extensive training and are interested in candidates with experience in medical billing, medical offices, patient accounts, insurance ...

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How much do medical insurance claims processor jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for medical insurance claims processor in Michigan is $18.34, according to ZipRecruiter salary data. Most workers in this role earn between $14.23 and $20.72 per hour, depending on experience, location, and employer.

What does a medical insurance claims processor do?

A Medical Insurance Claims Processor reviews and processes insurance claims submitted by healthcare providers or patients. They verify the accuracy of claim information, ensure services are covered by the patient’s insurance policy, and calculate the payment amounts. Claims processors also communicate with providers and policyholders to resolve discrepancies or request additional information when necessary. Their work helps ensure timely and accurate reimbursement for medical services.

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

To thrive as a Medical Insurance Claims Processor, you need a solid understanding of medical terminology, health insurance policies, and claims processing procedures, typically supported by a high school diploma or associate degree. Familiarity with claims management software, coding systems like ICD-10 and CPT, and electronic health record (EHR) platforms is essential. Attention to detail, analytical thinking, and strong communication skills help ensure accuracy and efficiency when handling sensitive information and resolving claim issues. These skills are crucial for minimizing errors, expediting claims resolution, and maintaining compliance with industry regulations.

What are some common challenges faced by medical insurance claims processors, and how can they be managed?

Medical Insurance Claims Processors often encounter challenges such as navigating complex insurance policies, dealing with frequent policy changes, and communicating with both providers and patients to resolve discrepancies. Staying organized and detail-oriented is crucial, as missing documentation or incorrect coding can delay claim approvals. Regularly attending training sessions on insurance regulations and collaborating closely with billing teams can help manage these challenges and ensure accurate, timely claim processing.

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

AspectMedical Insurance Claims ProcessorMedical Billing Specialist
CredentialsHigh school diploma; certifications like CPC or CPC-HHigh school diploma; certifications like CPC or CPC-H
Work EnvironmentHealthcare offices, insurance companiesHealthcare offices, billing departments
Primary ResponsibilitiesReview and process insurance claims, ensure accuracyGenerate bills, follow up on payments, manage accounts

While both roles involve healthcare billing and insurance, Medical Insurance Claims Processors focus on reviewing and submitting insurance claims, ensuring they are correctly processed. Medical Billing Specialists handle the entire billing cycle, including generating invoices and managing payments. Both roles require similar certifications and often work in healthcare or insurance settings, but their core functions differ in scope and daily tasks.

How to become a medical insurance claims processor?

To become a medical insurance claims processor, typically one needs a high school diploma or equivalent, along with training in healthcare billing and coding. Many employers prefer candidates with knowledge of medical terminology, insurance policies, and experience with claims processing software; certifications such as Certified Professional Coder (CPC) can also enhance job prospects.

Is a medical insurance claims processor job in demand?

The demand for medical insurance claims processors remains steady due to ongoing healthcare industry needs and the increasing complexity of insurance claims. Employment in this field is expected to grow as healthcare providers and insurers seek skilled workers familiar with claims processing software and regulations. Certification and experience can enhance job prospects in this role.

What are popular job titles related to Medical Insurance Claims Processor jobs in Michigan?

For Medical Insurance Claims Processor jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching Medical Insurance Claims Processor jobs in Michigan look for?

The top searched job categories for Medical Insurance Claims Processor jobs in Michigan are:

What are popular job titles related to Medical Insurance Claims Processor jobs in MI?

For Medical Insurance Claims Processor jobs in MI, the most frequently searched job titles are:

Medical Insurance Claims Processor jobs near you
Infographic showing various Medical Insurance Claims Processor job openings in Michigan as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 16% Part Time, 2% Temporary, 7% Contract, and 1% Nights. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $38,143 per year, or $18.3 per hour.

Clinical Denials Specialist

Healthrise

Farmington Hills, MI • On-site

$17.75 - $23.50/hr

Full-time

Re-posted 1 hour ago

Job description

Description:

The Clinical Denial Specialist plays a vital role in ensuring accurate reimbursement for healthcare services by reviewing denied claims, identifying denial reasons, and appealing claim denials. They collaborate with healthcare providers to gather necessary documentation and evidence for appeals, analyze denial trends, and provide feedback to improve revenue cycle processes. 


Duties and Responsibilities 

  • Ability to analyze denial reasons and trends to identify opportunities for process improvement. 
  • Excellent verbal and written communication skills to effectively collaborate with healthcare providers and present appeal arguments. 
  • Keen attention to detail to ensure accurate review and analysis of denied claims and medical records. 
  • Strong problem-solving skills to develop effective appeal strategies and overcome denial challenges. 
  • Understanding of medical terminology, coding principles, and reimbursement guidelines to assess denial reasons and appeal opportunities. 
  • Ability to adapt to changing payer policies, regulations, and reimbursement requirements. 
  • Review denied claims to identify denial reasons and discrepancies. 
  • Analyze medical records, billing documents, and payer policies to prepare appeal arguments. 
  • Collaborate with healthcare providers to gather additional documentation and evidence for appeals. 
  • Document appeal activities, correspondence, and outcomes for tracking and reporting purposes. 
  • Monitor denial trends and provide feedback to revenue cycle teams to prevent future denials. 
  • Participate in denial management meetings and contribute insights to improve denial prevention strategies. 
  • Stay updated on payer policies, regulations, and reimbursement guidelines relevant to claim denials. 
Requirements:
  • Bachelor's degree in healthcare administration, nursing, health information management, or a related field. 
  • Clinical designated nurse, RN credentials (denials/CDI) 
  • Minimum of 2-3 years of experience in healthcare revenue cycle management, medical billing, claims processing, or denial management. 

Physical Demands and Work Environment 

  • Work Environment: This job operates in a professional home environment. This role routinely uses standard office equipment such as computers, and phones. 
  • Physical Demands: This is largely a sedentary role; however, employees may need to use keyboards, mouse, and other devices for typing, clicking, and navigating software systems.