Medical / Health Claims Examiner Salary

Health Claims Examiners in the United States pull down an average of $17.23 per hour. Job satisfaction is reported as high by the vast majority of workers. Female Health Claims Examiners far outnumber their male contemporaries among survey respondents. Medical benefits are awarded to a strong majority, and the larger part earn dental coverage. This report is based on responses to the PayScale salary survey.

$29,684 - $54,170
(Median)
$30K
$40K
$54K
MEDIAN: $39,947
10%
50%
90%

Add this chart to your site: 640px    300px

$12.16 - $22.72
(Median)
$12
$17
$23
MEDIAN: $17.00
10%
50%
90%

Add this chart to your site: 640px    300px

National Salary Data (?
XAll compensation data shown are gross, national 10th to 90th percentile ranges. Pay can vary greatly by location. To view local data, take the PayScale survey.
)
$0$19K$38K$57K
Salary
$29,684 - $54,170  
   
Bonus
$0.00 - $2,978  
Profit Sharing
$101.74 - $3,931  
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).
)
$27,073 - $52,085  
Country: United States | Currency: USD | Updated: 2 Jul 2015 | Individuals Reporting: 106
National Hourly Rate Data (?
XAll compensation data shown are gross, national 10th to 90th percentile ranges. Pay can vary greatly by location. To view local data, take the PayScale survey.
)
$0$11$22$33
Hourly Rate
$12.16 - $22.72  
   
Overtime
$17.12 - $32.62  
National Annualized Data (?
XAll compensation data shown are gross, national 10th to 90th percentile ranges. Pay can vary greatly by location. To view local data, take the PayScale survey.
)
$0$22K$44K$66K
Bonus
$0.00 - $2,978  
   
Profit Sharing
$101.74 - $3,931  
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).
)
$27,073 - $52,085  
Country: United States | Currency: USD | Updated: 2 Jul 2015 | Individuals Reporting: 176
United States (change)

Find Out Exactly What You Should Be Paid

United States (change)


Comp Managers: Start Here »

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.

Read More...

Medical / Health Claims Examiner Tasks

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

Medical / Health Claims Examiner Job Listings

Search for more jobs:


Survey results show that Health Claims Examiners typically report just a few professional skills. Medical Coding and Claim Handling are considered valuable skills and can increase employee pay. Skills that are correlated to lower pay, on the other hand, include Claim Handling and Medical Coding.

Pay by Experience Level for Medical / Health Claims Examiner

Median of all compensation (including tips, bonus, and overtime) by years of experience.


Health Claims Examiners do not generally earn higher incomes from more experience in the field. The average inexperienced worker earns $36K, and someone who has worked for five to 10 years can expect a bigger median salary of $38K. On average, Health Claims Examiners make $40K following one to two decades on the job. Respondents who claim more than 20 years of experience may encounter pay that doesn't quite reflect their extensive experience; these veterans report a median income of around $41K.

Related Job Salaries

United States (change)

Find Out Exactly What You Should Be Paid

United States (change)


Comp Managers: Start Here »

Experience Affects Medical / Health Claims Examiner Salaries

Late-Career
up arrow 8%

Experienced
up arrow 4%

National Average
$38,000

Mid-Career
up arrow 2%

Entry-Level
up arrow 7%

Skills That Affect Medical / Health Claims Examiner Salaries

National Average
$38,000


Claim Handling
up arrow 11%

Job Satisfaction

Extremely satisfied
Rated 5 out of 5
based on 51 votes.

Gender

Female
90 %
Male
10 %

Years of Experience

Less than 1 year
4%
1-4 years
29%
5-9 years
23%
10-19 years
23%
20 years or more
21%

Common Health Benefits

medical benefits Medical: 79% dental benefits Dental: 69%
vision benefits Vision: 61% employee benefits None: 18%
ADVERTISEMENT