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Optum Health Claims Processing Jobs (NOW HIRING)

Deloitte

Mainframe Developer

Atlanta, GA · 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 ...

WebTPA

Claims Examiner I

San Antonio, TX · Remote

As a Claim Examiner, you will handle processing and adjudication for healthcare claims. This will include claims research where applicable and a range of claim complexity. What Will You Be Doing: Day ...

WellPsyche

Claims Follow-Up Lead-CA

Los Angeles, CA · Remote

$25 - $30/hr

Claims Follow-Up Lead Behavioral Health | Government & Commercial Payers | Lean Growth Organization ... VA Community Care (TriWest / Optum) * Submit appeals and corrected claims within timely filing ...

Citizens, Inc.

PR · On-site

Review and prepare claims for processing; maintain claims information in the claims app ... Associate, Life & Health Claims (ALHC) and Associate, Life Management Institute (ALMI ...

Deloitte

Mainframe Developer

Mclean, VA · On-site

$49.75 - $63.75/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 ...

Wellabe

Claims Specialist 1-Remote

Des Moines, IA · On-site +1

The Claims Specialist 1 is responsible for processing, reviewing, and adjusting routine life or health claims. Be successful in this role Someone in this role will: * Review, analyze and process ...

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Optum Health Claims Processing information

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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.
Part Time Claims Coordinator

Part Time Claims Coordinator

Advanced Behavioral Health, Inc

Middletown, CT • On-site

Part-time

Posted 14 days ago

Job description

POSITION SUMMARY:

Claims Coordinator Behavioral Health Claims & Managed Care | Part-Time | Hybrid | Middletown, CT – must be a CT resident

About ABH

ABH has been a cornerstone of Connecticut's behavioral health system partnering with state agencies, providers, and communities to strengthen access and quality of care across the state. As a nonprofit, we're driven by our mission.

We manage mental health and substance abuse services, provide customized technology to operate programs efficiently, and participate in research representing best practices in the field. Behind all of it is a dedicated team making sure the operational and financial infrastructure runs the way it should and that's where this role comes in.

If you are passionate about making a difference, aligned with our mission, and looking for a part-time opportunity that offers the flexibility to fit your life, we'd love to have you on our team.

DUTIES AND RESPONSIBILITIES:

  • Process and adjust claims for the BHRP-Clinical, BHRP-Basic, Military Support, and Pre-Trial Intervention programs
  • Conduct weekly claims audits with emphasis on high-dollar submissions and compile audit reports
  • Manage check runs and eligibility file uploads as needed
  • Assist with weekly and monthly financial reporting
  • Support the claims denial review process and special claims projects
  • Respond to provider and staff inquiries about claims status, eligibility, and benefits
  • Assist in training new and existing claims staff
  • Maintain working knowledge of CPT and ICD-10 codes, behavioral health insurance terminology, and HCFA/UB-04 claim form requirements
  • Uphold confidentiality of all protected health information in accordance with HIPAA policies

Work Arrangement

CT residence only - This is a part-time, hybrid position offering real flexibility. Much of this role's work can be performed remotely, and we support work-from-home when responsibilities and workflows allow for it.

Why Join ABH

  • Part-time schedule with genuine work-life flexibility
  • Hybrid work arrangement with meaningful WFH opportunity
  • Contribute to a mission-driven nonprofit that has been a cornerstone of Connecticut's behavioral health system
  • Collaborative team environment at a stable, established organization
  • Opportunities for growth across a diverse range of programs and functions

ABH is an equal opportunity employer committed to a diverse and inclusive workplace.

Requirements

EDUCATION AND EXPERIENCE REQUIREMENTS:

  • Associate’s degree/Bachelor’s preferred in business or related field preferred;
  • Three years of demonstrated work experience in claims processing or in the behavioral health customer service field;
  • Attends trainings specific to job duties;
  • Attends annual Conflict of Interest.

KNOWLEDGE/SKILLS/ABILITIES:

  • In-depth knowledge of ABH’s various utilization management and claims systems created by ABH and used by all the GA staff;
  • Must be flexible in order to respond quickly and positively to shifting demands;
  • Strong attention to detail; ability to work on multiple tasks and meet deadlines;
  • Excellent PC skills with demonstrated experience using Microsoft Office Package (MS Word, Excel, Outlook);
  • Strong written and verbal communication skills required.
  • Due to the need for in-person client support across Connecticut, this position requires residency within the state.