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Optum Health Claims Processing Jobs (NOW HIRING)

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY · On-site

$18.75 - $23.75/hr

Process and evaluate hospital claims manually or through claims work flow * Validate information ... Minimum two (2) years experience entering and updating hospital or medical claims in a health ...

1199SEIU Funds

Hospital Claims Processor V

Manhattan, NY · On-site

$18.75 - $23.75/hr

Process and evaluate hospital claims manually or through claims work flow * Validate information ... Minimum two (2) years experience entering and updating hospital or medical claims in a health ...

Conduent, Inc.

Claims Processing Clerk

Lexington, KY · On-site

$15/hr

Claims Processing Clerk Schedule: Full-Time Shift-Monday- Friday 8:00 AM - clean desk (based on ... Health benefits start Day 1 to include Medical, Dental, Vision and 401K savings plan * Growth ...

Conduent, Inc.

Claims Processing Clerk

Lexington, KY

$15/hr

Claims Processing Clerk Schedule: Full-Time Shift- Monday- Friday 8:00 AM - clean desk (based on ... Health benefits start Day 1 to include Medical, Dental, Vision and 401K savings plan * Growth ...

ProAg

National Claims Processing Manager

Lenexa, KS · On-site

National Claims Processing Manager Location: Lenexa, KS / Remote Reports to: Director of Insurance ... Access to our award-winning wellness program, including mental health services, fitness network ...

True Behavioral Health LP

Claim Specialist

Irvine, CA · On-site

$27 - $30/hr

... health billing workflows, including claim corrections, payer communication, and AR resolution. Responsibilities: • Claims Processing: Review and process incoming claims for accuracy, completeness ...

ProAg

National Claims Processing Manager

Lenexa, KS · On-site +1

National Claims Processing Manager Location: Lenexa, KS / Remote Reports to: Director of Insurance ... Access to our award-winning wellness program, including mental health services, fitness network ...

Deloitte

Mainframe Developer

San Francisco, CA · On-site

$57.75 - $74.25/hr

The role involves daily development, maintenance, and support of mainframe health claims applications, as well as developing and deploying code changes for claims processing systems. Responsibilities ...

Deloitte

Mainframe Developer

Tulsa, OK · On-site

$44.75 - $57.50/hr

The role involves daily development, maintenance, and support of mainframe health claims applications, as well as developing and deploying code changes for claims processing systems. Responsibilities ...

Deloitte

Mainframe Developer

Charlotte, NC · On-site

$47.75 - $61.50/hr

The role involves daily development, maintenance, and support of mainframe health claims applications, as well as developing and deploying code changes for claims processing systems. Responsibilities ...

Conduent, Inc.

Remote Claims Processing Clerk

KY · Remote

$15/hr

Remote Claims Processing Clerk Schedule: Monday- Friday 8:00 AM - clean desk (based on business ... Health benefits start Day 1 to include Medical, Dental, Vision and 401K savings plan * Growth ...

Deloitte

Mainframe Developer

Louisville, KY · On-site

$47 - $60.50/hr

The role involves daily development, maintenance, and support of mainframe health claims applications, as well as developing and deploying code changes for claims processing systems. Responsibilities ...

Deloitte

Mainframe Developer

Las Vegas, NV · On-site

$46.75 - $60.25/hr

The role involves daily development, maintenance, and support of mainframe health claims applications, as well as developing and deploying code changes for claims processing systems. Responsibilities ...

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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.
Claims Processing Specialist

Claims Processing Specialist

BLACKBURN'S PHYSICIANS PHARMACY

Tarentum, PA

Other

Posted 3 days ago

Job description

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

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