Claims Processor Healthcare

Claims Processor Healthcare Job Description

Claims processors must have claims adjudication experience and knowledge of CPTs, ICD-10 and billing guidelines for different types of healthcare coverage. Strong verbal and writing, Microsoft Office, research, and time-management skills are preferred. The position requires a high school diploma or the equivalent, as well as two to five years of claims processing and adjudication experience.

Typical claims processor duties:

Entering, processing and adjusting health claims in accordance with claims policies and procedures

Handling complex claims

Reviewing, analyzing, and processing claims and policies to determine the extent of the company’s liability and entitlement

Researching and analyzing claims issues

Responding to inquiries from customers and clients

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Salary for Claims Processor Healthcare

36250 - 46750

25th percentile

36250

The candidate is new to the role and building the needed skills, experience and autonomy.

50th percentile

40500

The candidate has the experience to perform core responsibilities without direct supervision and is comfortable with the role’s processes and subject matter.

75th percentile

46750

The candidate delivers value beyond the stated job duties, has advanced qualifications and experience, and is ready for the next career level.

Projected salaries for related positions

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25th percentile

50th percentile

75th percentile

Revenue Cycle Director – Healthcare

84500

109750

130250