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Optum Health Claims Processing Jobs (NOW HIRING)

TEEMA

Claims Reviewer

Phoenix, AZ · Remote

$26.40 - $27.88/hr

Familiarity with medical claims processing and terminology. * Preferred : * Coding experience. * Knowledge of behavioral health claims. Skills for Success * Strong technical skills in claims tools (e ...

Withum

Health Claims Audit Supervisor

San Ramon, CA · Hybrid

$85K - $110K/yr

Must have a minimum of 3-5 years of health claims processing experience (internal auditing skills a plus) * Good computer skills (Microsoft office preferred), excellent communication skills * Ability ...

TEEMA

Claims Reviewer

Phoenix, AZ · Remote

$25 - $29/hr

Conducts medical claims review using current claims processing guidelines and established clinical ... Knowledge of behavioral health claims review

Imagenet

Claims Examiner - Remote

Tampa, FL · Remote

Imagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission ...

ImagenetLLC

Claims Examiner - Remote

Tampa, FL · Remote

$17 - $18/hr

Imagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission ...

Imagenet

Claims Examiner - Remote

Jacksonville, NC · Remote

$17 - $18/hr

Imagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission ...

Imagenet

Claims Examiner - Remote

Boise, ID · Remote

$17 - $18/hr

Imagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission ...

ImageNetLLC

Claims Examiner - Remote

Tampa, FL · Remote

Imagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission ...

Imagenet

Claims Examiner - Remote

Saint Louis, MO · Remote

$17 - $18/hr

Imagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission ...

Imagenet

Claims Examiner - Remote

Tampa, FL · On-site +1

Imagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission ...

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All JobsOptum Health Claims Processing Jobs

Optum Health Claims Processing information

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$12

$19

$26

How much do optum health claims processing jobs pay per hour?

As of Jun 10, 2026, the average hourly pay for optum health 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 the difference between Optum Health Claims Processing vs Medical Claims Processor?

AspectOptum Health Claims ProcessingMedical Claims Processor
CredentialsTypically requires high school diploma or equivalent; certifications like CPC or CPC-A are commonUsually requires similar credentials, including CPC certification
Work EnvironmentCorporate office or remote healthcare settingHealthcare facilities or insurance companies
Industry UsageUsed across health insurance and healthcare management companiesPrimarily in insurance companies and healthcare providers
Job FocusProcessing and reviewing health insurance claims for OptumReviewing and processing medical claims for various insurers

Both roles involve processing health-related claims, often requiring similar certifications and working in healthcare or insurance environments. Optum Health Claims Processing specifically focuses on claims within Optum, a healthcare services company, while Medical Claims Processors work across multiple insurers and healthcare providers.

What is Optum Health claims processing?

Optum Health claims processing refers to the system and procedures used by Optum, a healthcare services company, to manage, review, and pay out health insurance claims submitted by providers and members. This process involves verifying the accuracy of submitted claims, checking patient eligibility, determining coverage, and ensuring compliance with regulations. Claims processors at Optum work to ensure timely payments and resolve any discrepancies or issues that may arise during the process. Efficient claims processing helps both healthcare providers and patients receive appropriate reimbursement and benefits.

What are the key skills and qualifications needed to thrive in Optum Health Claims Processing, and why are they important?

To thrive in Optum Health Claims Processing, you need strong analytical skills, attention to detail, and a good understanding of healthcare insurance concepts, typically supported by a high school diploma or equivalent. Familiarity with claims management software, coding systems (such as ICD-10 and CPT), and Microsoft Office tools is commonly required. Excellent communication, problem-solving abilities, and customer service orientation help individuals excel in this position. These skills ensure accurate and timely claims adjudication, minimize errors, and support customer satisfaction in a complex healthcare environment.

What are some common challenges faced in Optum Health Claims Processing, and how can new hires prepare for them?

In Optum Health Claims Processing, a frequent challenge is accurately reviewing and adjudicating high volumes of claims while adhering to strict deadlines and complex regulatory requirements. New hires can prepare by becoming familiar with industry-standard coding systems (such as ICD-10, CPT), learning about insurance terminology, and developing strong attention to detail. Collaborating closely with team members and seeking clarification when faced with ambiguous claims can also help ensure accuracy and efficiency. Training is typically provided, but proactive learning and open communication are key to overcoming initial hurdles in this fast-paced environment.
Infographic showing various Optum Health Claims Processing job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. 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.

Health Claims Audit Supervisor

WithumSmith+Brown

San Ramon, CA • Hybrid

$85K - $110K/yr

Other

Medical, Dental, Vision

Posted 6 days ago

Job description

Withum is seeking an experienced health claims audit supervisor possessing in-depth knowledge of group health and disability claims procedures, medical/dental terminology, including CPT, ADA, HCPC and ICDA codes, and a thorough understanding of automated health claims systems as well as manual claims payment systems.

How You'll Spend Your Time:

  • Working closely with our clients, and their vendors, to ensure that health, dental, prescription and vision claims are being paid in compliance with regulations and plan documents
  • Reviewing client's claims adjudication internal controls policies and procedures
  • Completing audit workpapers documenting procedures, findings and conclusions within assigned budgets and deadlines

The Kinds of People We Want to Talk to Have Many of the Following:

  • BS Degree
  • Must be qualified at analyzing and interpreting group health insurance contract provisions and reviewing administrative policies and PPO contracts
  • Experience working within a team environment
  • Must be familiar with HIPAA and ACA compliance standards
  • Must have a minimum of 3-5 years of health claims processing experience (internal auditing skills a plus)
  • Good computer skills (Microsoft office preferred), excellent communication skills
  • Ability to travel as needed based on client assignments 

The compensation range for this position is $85,000-$110,000. In addition to the base compensation, Withum offers a competitive benefits package and bonus program (for eligible roles) based on individual and firm performance. Final offer amounts are based on multiple factors such as the specific role, hiring location, as well as the individual's skills, experience, and qualifications. For additional information on our benefits, visit our website at https://www.withum.com/careers/.

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