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Medicare Claims Processing Jobs (NOW HIRING)

GlobalHealth, Inc

Claims Processor (52219)

Oklahoma City, OK · On-site +1

$15.75 - $20/hr

Working knowledge of medical claims processing guidelines and practices. * Knowledge of Medicare and Health Care Finance Administration regulations. * Knowledge of EOBs, CPT & ICD-10 codes, HCFAs ...

Highmark Health

Supervisor Appeals - Medicare

Identify opportunities, through the use of Medicare policies and procedures, claims processing procedures and related data processing systems, to improve the Organization'sMedicare Services overall ...

New

Peraton

Test Engineering, Senior Associate

$86K - $138K/yr

Responsibilities The Health and Financial Solutions team is looking for a Test Engineer to support the testing lifecycle for Medicare claims processing systems operating on a legacy mainframe ...

New

American Health Partners

Claims Auditor

Franklin, TN · Hybrid

Proficient in processing/auditing claims for Medicare and Medicaid plans * Strong knowledge of CMS requirements regarding claims processing, especially regarding skilled nursing facilities and other ...

SeniorLIFE of PA

Claims Processor - Johnstown

Johnstown, PA · On-site

$16.75 - $21.25/hr

Claims Processor Senior LIFE is an innovative home and community based Medicare and Medicaid funded program which provides all-inclusive healthcare services and support to seniors living in the ...

Senior LIFE

Claims Processor - Johnstown

Johnstown, PA · On-site

$16.75 - $21.25/hr

Overview Claims Processor Full Time - Johnstown, Pa Senior LIFE is an innovative home and community based Medicare and Medicaid funded program which provides all-inclusive healthcare services and ...

Senior LIFE

Claims Processor - Johnstown

Johnstown, PA · Hybrid

$15.50 - $19.75/hr

Overview Claims Processor Full Time - Johnstown, Pa Senior LIFE is an innovative home and community based Medicare and Medicaid funded program which provides all-inclusive healthcare services and ...

Sourcedge Solutions

FACETS Claims Processor

Albany, NY · Remote

$17 - $21.25/hr

Possess high productivity and quality standards within a claims processing automation environment * Knowledge of CPT, HCPC, ICD-10 codes * Knowledge of HMO, PPO, Medicare and Medicaid plans

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Medicare Claims Processing information

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How much do medicare claims processing jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for medicare claims processing in the United States is $19.16, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $20.67 per hour, depending on experience, location, and employer.

What is Medicare claims processing?

Medicare claims processing refers to the series of steps involved in reviewing, approving, and paying claims for healthcare services provided to Medicare beneficiaries. This process ensures that submitted claims meet Medicare’s rules and regulations and that providers are reimbursed correctly. Claims processors review documentation, verify patient eligibility, check for coding accuracy, and determine coverage based on Medicare guidelines. The process helps to prevent fraud, waste, and abuse while ensuring timely payment to healthcare providers.

What are the key skills and qualifications needed to thrive in Medicare claims processing, and why are they important?

To excel in Medicare Claims Processing, you need strong attention to detail, knowledge of healthcare billing procedures, and familiarity with Medicare regulations, often supported by experience or coursework in medical billing and coding. Proficiency with claims management software, electronic health record (EHR) systems, and understanding of ICD-10 and CPT coding are typically required. Excellent organizational skills, problem-solving abilities, and clear communication help professionals navigate complex claims and resolve issues efficiently. These skills ensure accurate, timely claims processing, minimize errors, and support compliance with Medicare guidelines, ultimately benefiting both providers and patients.

What are some common challenges faced in Medicare claims processing and how can I prepare for them?

Medicare claims processing specialists often encounter challenges such as navigating complex regulations, ensuring timely and accurate data entry, and resolving discrepancies or denials from insurance payers. To prepare, it's helpful to develop strong attention to detail, stay up to date on Medicare guidelines, and become proficient with claims management software. Regular communication with healthcare providers and insurance representatives is also crucial for resolving issues efficiently and ensuring claims are processed correctly.

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

AspectMedicare Claims ProcessingMedical Billing Specialist
CertificationsTypically requires claims processing training, possibly some Medicare-specific certificationsOften requires medical billing and coding certifications, such as CPC or CMA
Work EnvironmentHealthcare facilities, insurance companies, government agenciesMedical offices, clinics, healthcare billing companies
Job FocusReviewing, submitting, and managing Medicare claims for reimbursementPreparing and submitting medical bills to various insurance providers, including Medicare

Medicare Claims Processing involves handling Medicare-specific claims, ensuring compliance with government regulations. Medical Billing Specialists manage billing for various insurance types, including Medicare, focusing on accurate coding and documentation. While both roles require knowledge of healthcare billing, Medicare Claims Processing is more specialized in Medicare procedures and regulations.

How to get a job as a Medicare claims processor?

To become a Medicare claims processor, candidates typically need a high school diploma or equivalent, with some roles requiring postsecondary education or training in healthcare administration. Relevant skills include attention to detail, knowledge of medical billing and coding, and familiarity with claims processing software. Certification in medical billing or coding can improve job prospects, and positions often require working in a healthcare or administrative environment with standard office hours.

Is Medicare claims processing a stressful job?

Medicare claims processing can be stressful due to strict deadlines, high accuracy requirements, and the need to handle complex regulations. Employees often work in fast-paced environments and must pay close attention to detail, which can contribute to job-related stress.

Is a Medicare Claims Processing job in demand?

Medicare Claims Processing jobs are in demand due to the ongoing need for healthcare administration and the aging population. These roles often require knowledge of healthcare policies and claims software, and employment is expected to grow as healthcare services expand and evolve.
More about Medicare Claims Processing jobs

What are the most commonly searched types of Medicare Claims Processing jobs?

The most popular types of Medicare Claims Processing jobs are:

What states have the most Medicare Claims Processing jobs?

States with the most job openings for Medicare Claims Processing jobs include:

What job categories do people searching Medicare Claims Processing jobs look for?

The top searched job categories for Medicare Claims Processing jobs are:

Medicare Claims Processing jobs near you
Infographic showing various Medicare Claims Processing job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 1% Temporary, 3% Contract, and 1% Nights. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $39,863 per year, or $19.2 per hour.

Claims Processing Specialist - Tarentum, PA

Blackburn's

Tarentum, PA • On-site

Other

Posted 21 days ago

Job description

Claims Processing Specialist

Blackburn's Corporate - Tarentum, PA 15084

Overview: Category Insurance

Insurance Claims Specialist - DME/HME

Location: Tarentum, PA Department: Claims

At Blackburn's Physicians Pharmacy, we help patients gain access to the medical equipment and healthcare services they depend on every day. We are currently seeking an experienced Insurance Claims Coordinator to join our Claims team and support the processing, follow-up, and resolution of medical insurance claims within a fast-paced DME/HME environment.

This position is ideal for someone who is highly organized, detail-focused, and comfortable working with insurance documentation, billing systems, and payer communications.

About the Role

The Claims Specialist is responsible for reviewing and processing healthcare claims, tracking insurance requirements, and supporting reimbursement efforts for medical equipment and related services. This role works closely with internal departments, insurance companies, and healthcare providers to ensure claims are handled accurately and efficiently.

The right candidate will be proactive, dependable, and able to manage multiple priorities while maintaining a high level of accuracy.

Responsibilities
  • Review and process medical insurance claims in accordance with payer guidelines
  • Monitor claim status and perform follow-up on outstanding or denied claims
  • Verify documentation requirements and ensure records are complete before submission
  • Assist with insurance authorizations, reauthorizations, and prescription renewals
  • Communicate with insurance representatives regarding claim status, missing information, or denials
  • Work collaboratively with billing teams, customer service staff, and clinical departments
  • Maintain accurate account notes and supporting documentation
  • Prioritize daily workloads to meet filing deadlines and departmental goals
  • Identify recurring issues and help support process improvements to reduce delays and denials
  • Ensure compliance with company procedures and insurance regulations
What We Offer
  • Stable, full-time position with a growing healthcare organization
  • Supportive team environment with hands-on training
  • Opportunities for advancement and professional development
  • Competitive pay and benefits package
  • The opportunity to make a direct impact on patient care and service
Qualifications

What We're Looking For:

  • Previous experience in healthcare billing, claims processing, DME/HME, or insurance coordination preferred
  • Understanding of Medicare, Medicaid, and commercial insurance processes is a plus
  • Strong attention to detail and problem-solving skills
  • Excellent communication and organizational abilities
  • Ability to work independently and as part of a team
  • Comfortable working in a high-volume, deadline-driven environment
  • Basic proficiency with Microsoft Office and computer-based systems

Apply