Medical / Health Claims Examiner Salary

Health Claims Examiners in the United States take home approximately $17.64 per hour on average. Career length and the particular city each impact pay for this group, with the former having the largest influence. Job satisfaction for Health Claims Examiners is high. Medical benefits are awarded to a large number, and most earn dental coverage. There are far more female Health Claims Examiners who answered the questionnaire than men, making up 89 percent. The numbers in this rundown were provided by PayScale's salary survey participants.

$30,386 - $58,964
$30K
$42K
$59K
MEDIAN: $41,664
10%
50%
90%

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$12.86 - $23.47
$13
$18
$23
MEDIAN: $17.64
10%
50%
90%

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$0$58K
Salary $30,386 - $58,964
Bonus $0.00 - $2,061
Profit Sharing $1,250
Total Pay (?
XTotal Pay combines base annual salary or hourly wage, bonuses, profit sharing, tips, commissions, overtime pay and other forms of cash earnings, as applicable for this job. It does not include equity (stock) compensation, cash value of retirement benefits, or the value of other non-cash benefits (e.g. healthcare).
)
$28,822 - $54,232
  • Country: United States
  • Currency: USD
  • Updated: 11 Jul 2017
  • Individuals Reporting: 43
Hourly Data $0$35
Hourly Rate $12.86 - $23.47
Overtime $10.30 - $35.06
Annual Data $0$54K
Bonus $0.00 - $2,061
Profit Sharing $1,250
Total Pay (?
XTotal Pay combines base annual salary or hourly wage, bonuses, profit sharing, tips, commissions, overtime pay and other forms of cash earnings, as applicable for this job. It does not include equity (stock) compensation, cash value of retirement benefits, or the value of other non-cash benefits (e.g. healthcare).
)
$28,822 - $54,232
  • Country: United States
  • Currency: USD
  • Updated: 11 Jul 2017
  • Individuals Reporting: 127

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Job Description for Medical / Health Claims Examiner

Medical and health claims examiners generally work in an office setting, but may be required to go into the field if a situation requires hands-on investigation. Those in this position serve customers of medical insurance companies by determining insurance coverage, claim examination, and resolution, as well as maintaining and documenting customer service actions and ensuring legal compliance. They also determine covered medical insurance losses according to policies/certificates, establish proof of losses by analyzing medical documentation, provide support to legal actions by assembling documentation for settlements, and, if necessary, assemble further information from outside sources and witnesses.

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Medical / Health Claims Examiner Tasks

  • Make claim settlement determinations to authorize or deny payment based on policy and practices.
  • Update claims with additional information as required and monitor itemized billings for unauthorized charges.
  • Examine and verify accuracy and completeness of complex medical claims according to regulatory guidelines.

Medical / Health Claims Examiner Job Listings

Pay by Experience Level for Medical / Health Claims Examiner

Pay by Experience for a Medical / Health Claims Examiner has a positive trend. An entry-level Medical / Health Claims Examiner with less than 5 years of experience can expect to earn an average total compensation of $33,000 based on 64 salaries provided by anonymous users. Average total compensation includes tips, bonus, and overtime pay. A Medical / Health Claims Examiner with mid-career experience which includes employees with 5 to 10 years of experience can expect to earn an average total compensation of $40,000 based on 52 salaries. An experienced Medical / Health Claims Examiner which includes employees with 10 to 20 years of experience can expect to earn an average total compensation of $39,000 based on 63 salaries. A Medical / Health Claims Examiner with late-career experience which includes employees with greater than 20 years of experience can expect to earn an average total compensation of $42,000 based on 29 salaries.

Medical / Health Claims Examiner Advice

Q: What is it like working as a Medical / Health Claims Examiner?

Medical / Health Claims Examiner in San Antonio:
"Office politics."
Always paY attention to diagnosis.

Related Job Salaries

Key Stats for Medical / Health Claims Examiner

Gender

Female
89 %
Male
11 %

Job Satisfaction

Highly satisfied
Rated 4 out of 5
based on 29 votes.
Less than 1 year
5%
1-4 years
28%
5-9 years
19%
10-19 years
32%
20 years or more
17%
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Location:
Years in Fields/Career:
United States (change)

Experience Affects Medical / Health Claims Examiner Salaries

▲10%

▲3%

▼0%

National Average
$39,000

Entry-Level
▼14%

Skills That Affect Medical / Health Claims Examiner Salaries

Electronic Medical Records (EMR)
▲4%

National Average
$39,000


Current Procedural Terminology (CPT) Coding
▼3%


Medicaid & Medicare Billing
▼7%

Claim Handling
▼8%

Job Satisfaction

Highly satisfied
Rated 4 out of 5
based on 29 votes.

Gender

Female
89 %
Male
11 %

Years of Experience

Less than 1 year
5%
1-4 years
28%
5-9 years
19%
10-19 years
32%
20 years or more
17%

Common Health Benefits

medical benefits
Medical: 89%
dental benefits
Dental: 81%
vision benefits
Vision: 71%
no benefits
None: 7%
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