How to hire a Medical Claims Processor

How to hire a medical claims processor, step by step

Here's a step-by-step medical claims processor hiring guide:

• Step 1: Identify your hiring needs
• Step 2: Create an ideal candidate profile
• Step 3: Make a budget
• Step 4: Write a medical claims processor job description
• Step 5: Post your job
• Step 6: Interview candidates
• Step 7: Send a job offer and onboard your new medical claims processor
• Step 8: Go through the hiring process checklist

What does a Medical Claims Processor do?

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1. Identify your hiring needs

   The medical claims processor hiring process starts by determining what type of worker you actually need. Certain roles might require a full-time employee, whereas part-time workers or contractors can do others.

   Determine Employee vs Contractor Status

   Is the person you're thinking of hiring a US citizen or green card holder?

   Yes

   No

   A medical claims processor's background is also an important factor in determining whether they'll be a good fit for the position. For example, medical claims processors from different industries or fields will have radically different experiences and will bring different viewpoints to the role. You also need to consider the candidate's previous level of experience to make sure they'll be comfortable with the job's level of seniority.

   This list presents medical claims processor salaries for various positions.

   Type Of Medical Claims Processor	Description	Hourly Rate
   Medical Claims Processor	Financial clerks do administrative work for many types of organizations. They keep records, help customers, and carry out financial transactions.	$13-21
   Billing Representative	A billing representative assists with the overall operations of the organization's billing department. Billing representatives post payments timely on the database, update account statements, generate financial reports, release invoices, and resolve account discrepancies... Show More	$13-20
   Insurance Clerk	An insurance clerk usually works to process insurance, reinstatement, changes, or cancellations for a company or an individual account. They are responsible for monitoring, processing, and organizing different insurance claims for a client... Show More	$12-18

   Show more

2. Create an ideal candidate profile

   Common Skills:

   • Patients
   • Healthcare
   • Data Entry
   • Medical Insurance Claims
   • Medical Terminology
   • Customer Service
   • ICD-9
   • CPT-4
   • Medicaid
   • EOB
   • Process Claims
   • Medical Charts
   • HCPCS
   • Medical Bills

   Check All Skills

   Responsibilities:

   • Enter UB 92 and 1500 HCFA medical claims into computer system manage and process insurance claims.
   • Manage cases by aggressively directing the litigation process.
   • Submit medical claims to commercial insurance companies, Medicare, and Medicaid for payment with use of ICD-9 and CPT coding.
   • Review and verify patient account information against insurance program specifications, analyze surgical procedures and diagnoses using CPT-4 and ICD-9 codes.
   • Acknowledge and enforces confidentiality in alignment with (HIPPA) guidelines.
   • Audit encounters and ICD-10 codes to ensure correct coding and maximum reimbursement.

   More Medical Claims Processor duties

3. Make a budget

   Including a salary range in your medical claims processor job description is one of the best ways to attract top talent. A medical claims processor can vary based on:

   • Location. For example, medical claims processors' average salary in south carolina is 40% less than in delaware.
   • Seniority. Entry-level medical claims processors 36% less than senior-level medical claims processors.
   • Certifications. A medical claims processor with certifications usually earns a higher salary.
   • Company. Working for an established firm or a new start-up company can make a big difference in a medical claims processor's salary.

   Average medical claims processor salary

   $36,777yearly

   $17.68 hourly rate

   ---

   Entry-level medical claims processor salary

   $29,000 yearly salary

   Updated March 14, 2025

   Average medical claims processor salary by state

   Rank	State	Avg. Salary	Hourly Rate
   1	Delaware	$46,894	$23
   2	Connecticut	$46,411	$22
   3	Nevada	$45,565	$22
   4	New Hampshire	$45,137	$22
   5	New York	$43,731	$21
   6	Massachusetts	$43,727	$21
   7	California	$42,576	$20
   8	Kansas	$41,831	$20
   9	Minnesota	$40,845	$20
   10	West Virginia	$40,637	$20
   11	Maryland	$40,636	$20
   12	North Dakota	$39,817	$19
   13	Pennsylvania	$39,084	$19
   14	Georgia	$37,238	$18
   15	Colorado	$36,917	$18
   16	Virginia	$36,656	$18
   17	Florida	$36,197	$17
   18	Michigan	$36,157	$17
   19	Ohio	$35,226	$17
   20	Missouri	$35,088	$17

   Average medical claims processor salary by company

   Company

   Rank	Company	Average Salary	Hourly Rate	Job Openings
   1	Cognizant	$52,203	$25.10
   2	University of Michigan	$41,222	$19.82	8
   3	Guardant Health	$40,969	$19.70	2
   4	Ciox Health	$38,392	$18.46
   5	Moda Health	$37,539	$18.05	2
   6	Ods Technologies, L.P.	$37,289	$17.93
   7	Sedgwick LLP	$36,919	$17.75	936
   8	Rotech Healthcare	$36,628	$17.61	2
   9	Robert Half	$36,459	$17.53	56
   10	Quest Diagnostics	$36,376	$17.49	15
   11	Laboratory Corporation of America Holdings	$35,795	$17.21	16
   12	Randstad North America, Inc.	$35,683	$17.16	5
   13	trak group	$35,558	$17.10
   14	Kelly Services	$35,497	$17.07	24
   15	Staffing.com	$34,763	$16.71	2
   16	Aerotek	$34,583	$16.63	24
   17	ManpowerGroup	$34,469	$16.57	18
   18	CornerStone Staffing	$34,261	$16.47
   19	PrideStaff	$34,025	$16.36

4. Writing a Medical Claims Processor Job Description

   A job description for a medical claims processor role includes a summary of the job's main responsibilities, required skills, and preferred background experience. Including a salary range can also go a long way in attracting more candidates to apply, and showing the first name of the hiring manager can also make applicants more comfortable. As an example, here's a medical claims processor job description:

   Medical Claims Processor job description example

   Reports to Manager, BMG. Processes patient health information which includes prepping, scanning, and quality review of documents scanned into the electronic health record system. Analyzes electronic health records for documentation deficiencies and completeness.
   MISSION, VALUES and SERVICE GOALS
   MISSION: We deliver outstanding care, inspire health, and connect with heart. VALUES: Trust. Respect. Integrity. Compassion. SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.
   Productivity
   Processes records in a timely fashion to meet department productivity standards: 30 pages/min = 5, 23 pages/min = 4, 17 pages/min = 3, 11 pages/min = 2, below 11 pages/min = 1. Faxes reports to appropriate physicians/providers immediately for continuation of care. Document Scanning to be completed within 1-2 business days.
   Analysis to be completed within 5 days of discharge.
   Documentation sent to appropriate provider for review.
   Competency
   Preps/scans and indexes all records per department policy quality standards: 100-98% = 5, 97-95% = 4, 94-90% = 3, 89-85% = 2, 84% and below = 1. Faxes medical records as needed for continuing patient care purposes. This includes sending the correct information to the correct fax number. Clocks in and out and requests time off/flex time in compliance with department policy. Follows policy related to allotted break and lunch times. Operating standard equipment (i.e.: computer, fax/copier and scanners) as needed.
   Teamwork
   Attends meetings as scheduled, participates in group discussions & provides feedback/input regularly. Participates in huddles as scheduled, participates in huddle discussions and provides feedback/input regularly. Communicates issues/concerns to management team for problem resolution. Monitors supplies and reports low inventory to management team/secretary (includes scanner supplies). Provides assistance/training to coworkers with questions regarding work processes continuing patient care medical record requests.
   Customer Service
   Answers telephone calls promptly and courteously within 3 rings. Processes all continuing patient care medical record requests in a timely fashion without assistance. Assists patients/customers with requesting medical records and answers patients/customers questions. Includes management when appropriate.
   Contribute to the overall effectiveness of the department
   Completes other job-related duties and projects as assigned. ORGANIZATIONAL RESPONSIBILITIES
   
   Associate complies with the following organizational requirements:
   Attends and participates in department meetings and is accountable for all information shared. Completes mandatory education, annual competencies and department specific education within established timeframes. Completes annual employee health requirements within established timeframes. Maintains license/certification, registration in good standing throughout fiscal year. Direct patient care providers are required to maintain cur rent BCLS (CPR) and other certifications as required by position/department. Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self. Adheres to regulatory agency requirements, survey process and compliance. Complies with established organization and department policies. Available to work overtime in addition to working additional or other shifts and schedules when required.
   Commitment to Beacon's six-point Operating System, referred to as The Beacon Way: Leverage innovation everywhere. Cultivate human talent. Embrace performance improvement. Build greatness through accountability. Use information to improve and advance. Communicate clearly and continuously.
   
   Education and Experience The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a high school diploma or equivalent. Education/Training in medical records and/or medical terminology preferred.
   Knowledge & Skills
   Medical terminology, legal aspects of the medical information and confidentiality. Requires the computer skills necessary to complete work assignments accurately and in a reasonable amount of time. Demonstrates the interpersonal and communication skills (both verbal and written) necessary to interact effectively with a wide range of internal and external contacts. Demonstrates ability to work in a team environment with other clerical and clinical staff and with physicians.
   Working Conditions
   Works in a medical office environment.
   Physical Demands
   Moderate lifting, bending, stooping and overhead filing. Prolonged sitting.

   Copy This Example

   

5. Post your job

   There are various strategies that you can use to find the right medical claims processor for your business:

   • Consider promoting from within or recruiting from your existing workforce.
   • Ask for referrals from friends, family members, and current employees.
   • Attend job fairs at local colleges to find candidates who meet your education requirements.
   • Use social media platforms like LinkedIn, Facebook, and Twitter to reach potential job candidates.

   Post your job online:

   • Post your medical claims processor job on Zippia to find and recruit medical claims processor candidates who meet your exact specifications.
   • Use field-specific websites.
   • Post a job on free websites.

6. Interview candidates

   Your first interview with medical claims processor candidates should focus on their interest in the role and background experience. As the hiring process goes on, you can learn more about how they'd fit into the company culture in later rounds of interviews.

   You should also ask about candidates' unique skills and talents to see if they match the ideal candidate profile you developed earlier. Candidates good enough for the next step can complete the technical interview.

   The right interview questions can help you assess a candidate's hard skills, behavioral intelligence, and soft skills.

7. Send a job offer and onboard your new medical claims processor

   Once you've selected the best medical claims processor candidate for the job, it's time to write an offer letter. In addition to salary, this letter should include details about the benefits and perks you offer the candidate. Ensuring that your offer is competitive is essential, as qualified candidates may be considering other job opportunities. The candidate may wish to negotiate the terms of the offer, and you should be open to discussion. After you reach an agreement, the final step is formalizing the agreement with a contract.

   It's also good etiquette to follow up with applicants who don't get the job by sending them an email letting them know that the position has been filled.

   To prepare for the new medical claims processor first day, you should share an onboarding schedule with them that covers their first period on the job. You should also quickly complete any necessary paperwork, such as employee action forms and onboarding documents like I-9, benefits enrollment, and federal and state tax forms. Finally, Human Resources must ensure a new employee file is created for internal record keeping.

8. Go through the hiring process checklist

   • Determine employee type (full-time, part-time, contractor, etc.)
   • Submit a job requisition form to the HR department
   • Define job responsibilities and requirements
   • Establish budget and timeline
   • Determine hiring decision makers for the role
   • Write job description
   • Post job on job boards, company website, etc.
   • Promote the job internally
   • Process applications through applicant tracking system
   • Review resumes and cover letters
   • Shortlist candidates for screening
   • Hold phone/virtual interview screening with first round of candidates
   • Conduct in-person interviews with top candidates from first round
   • Score candidates based on weighted criteria (e.g., experience, education, background, cultural fit, skill set, etc.)
   • Conduct background checks on top candidates
   • Check references of top candidates
   • Consult with HR and hiring decision makers on job offer specifics
   • Extend offer to top candidate(s)
   • Receive formal job offer acceptance and signed employment contract
   • Inform other candidates that the position has been filled
   • Set and communicate onboarding schedule to new hire(s)
   • Complete new hire paperwork (i9, benefits enrollment, tax forms, etc.)

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