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I have been in the process of rebuilding my credit. I have obtained 2 small loans and also financed a mini vvan. would paying off my medical bill of 292 affect my score
No paying it off would not affect your score either way. The damage was done when it hit your reports. Your best bet is to arrange a Pay for Delete with the Collection Agency - You pay, they delete.
Edited: Then YES it would affect your score - if it is your most recent collection that is. If so you could get quite a few points.
Is your medical bill showing up as an adverse trade line on your credit report? In other words is it in a collection status?