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Claims Processor—Healthcare

Claims Processor—Healthcare Job Description

Healthcare claims processors ensure accurate and timely processing of medical claims. They review, verify and input insurance claims data, working closely with healthcare providers, insurance companies and patients to resolve discrepancies and support reimbursement processes. This role is ideal for professionals with strong attention to detail and a commitment to maintaining compliance in a fast-paced healthcare environment.

Typical claims processor—healthcare duties:

Review and process medical claims for accuracy, completeness and compliance with payer requirementsVerify patient information, insurance coverage and coding accuracyEnter claims data into processing systems and update records as neededCommunicate with healthcare providers, insurance carriers and patients to resolve claim issuesIdentify and flag discrepancies, denials or incomplete documentation for follow-upEnsure adherence to HIPAA regulations and organizational policiesMonitor claim status and follow up on pending or denied claimsAssist with appeals and resubmissions as necessaryMaintain organized records and documentation for audit readinessCollaborate with billing and revenue cycle teams to support timely reimbursement

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Salary for Claims Processor—Healthcare
36750 - 47250
Low
36750
The candidate is new to the role or has limited experience and is building necessary skills.
Mid
40750
The candidate has moderate experience in the role, meets most requirements or has equivalent transferable skills, and may also have relevant certifications.
High
47250
The candidate has extensive experience and advanced skills for the role, and may also have specialized certifications.
Projected salaries for related positions Job title Low Mid High Revenue Cycle Director 86000 111250 132250 Revenue Cycle Analyst 51250 65750 75250 Medical Billing/Collections Manager 86500 96250 106000 Medical Billing/Collections Supervisor 61500 75250 87500 Claims Examiner Analyst 47250 57750 67750 Denials Specialist 37500 43000 50500 Medical Collections Specialist 39500 43000 51250 Medical Biller 39500 42750 50000 Payment Poster 37500 42000 46750 Charge Entry Clerk 37000 40750 46250

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Our starting salary projections come from a rigorous, multistep process so that our numbers accurately reflect the marketplace. They are based on actual compensation for professionals Robert Half has matched with employers across the country and third-party job posting data from Textkernel that we use to independently validate the salary levels. Starting compensation—pay for someone new to a role—can vary significantly based on a candidate’s skills, experience and certifications, as well as other factors including industry, company size and revenue, and demand for the role. To reflect this variability, we report our salary data in three levels: low, mid and high.