How To Become A Medical Claims Processor: What It Is and Career Path

What is a medical claims processor and how to become one

Updated January 8, 2025

4 min read

Quoted expert

Eve Leija AAS, NCMA

If you're going to be a medical claims processor, you have to be meticulous, organized, and detail-oriented. Reviewing, validating, and processing insurance claims are your main duties, but you have to do a variety of tasks as well. To be able to do the job effectively, you have to be knowledgeable with the coding systems of the International Classification of Diseases (ICD) and with the Current Procedural Terminology (CPT). There is no specific college degree required to be a medical claims processor; however, an allied health-related course or a business degree is going to be an asset if you are pursuing this line of work.

As a medical claims processor, you are expected to have a top-notch record management system, strong attention to detail, and computer proficiency. Good communication skills are also required because you will be coordinating with doctors, patients, and insurance representatives as you process claims.

What general advice would you give to a medical claims processor?

Eve Leija AAS, NCMA

Medical Assistant Program Director, Website

To maximize salary for a medical assistant obtaining certification from one of the credentialing organizations such as American Association of Medical Assistants (AAMA) can make a new hire more competitive. Continuing educations along with developing any specialized skills such as phlebotomy. Demonstrating professionalism initiative and reliability, along with gaining a strong reference from previous employers.

ScoreMedical Claims ProcessorUS Average

Salary

2.9

Avg. Salary $36,777

Avg. Salary $59,228

Stability level

6.2

Growth rate -3%

Growth rate 0.3%

Diversity

6.7

Race

American Indian and Alaska Native 0.48%

Asian 3.89%

Black or African American 13.78%

Hispanic or Latino 14.38%

Unknown 4.28%

White 63.20%

Gender

female 84.05%

male 15.95%

Age - 44

Race

American Indian and Alaska Native 3.00%

Asian 7.00%

Black or African American 14.00%

Hispanic or Latino 19.00%

White 57.00%

Gender

female 47.00%

male 53.00%

Age - 44

Stress level

6.2

Stress level is manageable

7.1 - high

Complexity level

6.4

Complexity level is intermediate

7 - challenging

Work life balance

9.5

Work life balance is excellent

6.4 - fair

Key steps to become a medical claims processor

Explore medical claims processor education requirements

Most common medical claims processor degrees

Bachelor's

28.6 %

Associate

27.3 %

High School Diploma

20.9 %

Start to develop specific medical claims processor skills

Skills	Percentages
Patients	13.00%
Healthcare	9.81%
Data Entry	9.50%
Medical Insurance Claims	9.04%
Medical Terminology	6.02%

Complete relevant medical claims processor training and internships

Accountants spend an average of 1-3 months on post-employment, on-the-job training. New medical claims processors learn the skills and techniques required for their job and employer during this time. The chart below shows how long it takes to gain competency as a medical claims processor based on U.S. Bureau of Labor Statistics data and data from real medical claims processor resumes.

Gain additional medical claims processor certifications

Medical claims processor certifications can show employers you have a baseline of knowledge expected for the position. Certifications can also make you a more competitive candidate. Even if employers don't require a specific medical claims processor certification, having one may help you stand out relative to other applicants.

The most common certifications for medical claims processors include Medical Assistant and Certified Billing and Coding Specialist (CBCS).

More About Certifications

Research medical claims processor duties and 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.

Prepare your medical claims processor resume

When your background is strong enough, you can start writing your medical claims processor resume.

You can use Zippia's AI resume builder to make the resume writing process easier while also making sure that you include key information that hiring managers expect to see on a medical claims processor resume. You'll find resume tips and examples of skills, responsibilities, and summaries, all provided by Zippi, your career sidekick.

Choose from 10+ customizable medical claims processor resume templates

Build a professional medical claims processor resume in minutes. Browse through our resume examples to identify the best way to word your resume. Then choose from 10+ resume templates to create your medical claims processor resume.