Medical / Health Claims Examiner Salary

Health Claims Examiners in the United States are largely women. The group as a whole has a nationwide average of $17.38 per hour for pay. Career length and the particular city each impact pay for this group, with the former having the largest influence. A large number report receiving medical coverage from their employers and a fair number collect dental insurance. Job satisfaction is reported as high by the vast majority of workers.

$30,037 - $56,512
$30K
$41K
$57K
MEDIAN: $41,290
10%
50%
90%

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$12.46 - $22.92
$12
$17
$23
MEDIAN: $17.38
10%
50%
90%

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National Salary Data (?
XAll compensation data shown are gross 10th to 90th percentile ranges. Take the PayScale Survey to find out how location influences pay for this job.
)
$0$19K$38K$57K
Salary
$30,037 - $56,512  
   
Bonus
$-0.49 - $2,013  
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).
)
$27,614 - $53,380  
Country: United States | Currency: USD | Updated: 25 Mar 2017 | Individuals Reporting: 50
National Hourly Rate Data (?
XAll compensation data shown are gross 10th to 90th percentile ranges. Take the PayScale Survey to find out how location influences pay for this job.
)
$0$12$24$36
Hourly Rate
$12.46 - $22.92  
   
Overtime
$15.90 - $35.06  
National Annualized Data (?
XAll compensation data shown are gross 10th to 90th percentile ranges. Take the PayScale Survey to find out how location influences pay for this job.
)
$0$24K$48K$72K
Bonus
$-0.49 - $2,013  
   
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).
)
$27,614 - $53,380  
Country: United States | Currency: USD | Updated: 25 Mar 2017 | Individuals Reporting: 126

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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

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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.

Related Job Salaries

Key Stats for Medical / Health Claims Examiner

Gender

Female
91 %
Male
9 %

Job Satisfaction

Extremely satisfied
Rated 5 out of 5
based on 26 votes.
Less than 1 year
5%
1-4 years
28%
5-9 years
19%
10-19 years
32%
20 years or more
16%
Location:
Years in Fields/Career:
United States (change)

Experience Affects Medical / Health Claims Examiner Salaries

▲13%

▲6%

▲3%

National Average
$38,000

Entry-Level
▼11%

Skills That Affect Medical / Health Claims Examiner Salaries

Electronic Medical Records (EMR)
▲7%


Current Procedural Terminology (CPT) Coding
▼0%

National Average
$38,000


Medicaid & Medicare Billing
▼4%

Claim Handling
▼6%

Job Satisfaction

Extremely satisfied
Rated 5 out of 5
based on 26 votes.

Gender

Female
91 %
Male
9 %

Years of Experience

Less than 1 year
5%
1-4 years
28%
5-9 years
19%
10-19 years
32%
20 years or more
16%

Common Health Benefits

medical benefits
Medical: 85%
dental benefits
Dental: 75%
vision benefits
Vision: 64%
no benefits
None: 13%