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Adjustment Specialist Jobs (NOW HIRING)

MetroPlusHealth

Risk Adjustment Specialist

Manhattan, NY · Hybrid

$72K - $82K/yr

As a Risk Adjustment Specialist, you will support ongoing processes and lead projects to ensure MetroPlusHealth is fully capturing data about our high-risk populations and submitting accurate ...

MetroPlusHealth

Risk Adjustment Specialist

Manhattan, NY · On-site

$72K - $82K/yr

As a Risk Adjustment Specialist, you will support ongoing processes and lead projects to ensure MetroPlusHealth is fully capturing data about our high-risk populations and submitting accurate ...

Centene

Risk Adjustment Specialist (Non-Clinical)

$23.23 - $39.61/hr

Use various vendor portals to identify barriers that are keeping health plan from receiving medical records for risk adjustment purposes. Research provider information using internal systems and ...

Associa

Accounts Receivable Adjustment

Richardson, TX · On-site

$18.25 - $24.25/hr

Job Summary The Accounts Receivable Adjustments Specialist will process branch requests to reconcile transactions. This is an accounting support position in a fast paced centralized accounting ...

Memorial Health

Credit/ Refund Specialist

Springfield, IL · On-site

$18.34 - $28.42/hr

Initiates contractual adjustments on the account and/or processes refunds to patients, governmental ... Experience: Two or more years as a Billing Adjustment Specialist, or comparable insurance ...

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Adjustment Specialist information

What is an adjustment specialist?

Adjustment Specialists are professionals who review, process, and resolve discrepancies or issues related to financial accounts, insurance claims, billing statements, or customer accounts. They analyze adjustment requests, verify supporting documentation, and make necessary corrections to ensure accounts are accurate and compliant with company policies. Adjustment Specialists often communicate with clients, internal departments, or external partners to gather information and resolve issues efficiently. This role requires strong attention to detail, analytical skills, and a good understanding of relevant regulations and procedures.

What are the key skills and qualifications needed to thrive as an adjustment specialist?

To thrive as an Adjustment Specialist, you need strong analytical skills, attention to detail, and a background in finance, insurance, or a related field—often supported by relevant certifications or experience. Familiarity with claims management software and industry-specific databases is typically required. Excellent communication, negotiation, and problem-solving skills help in resolving client issues and facilitating settlements. These skills and qualities ensure accurate, fair, and efficient processing of claims, fostering trust and satisfaction among clients and stakeholders.

What are some common challenges adjustment specialists face when handling complex claims, and how can they effectively address them?

Adjustment Specialists often encounter complex claims that require thorough investigation, careful documentation, and clear communication with multiple parties. Challenges may include gathering accurate information from clients, negotiating settlements, and navigating regulatory requirements. To address these issues effectively, Adjustment Specialists should stay organized, maintain up-to-date knowledge of industry regulations, and develop strong interpersonal skills to resolve disputes amicably. Collaborating closely with colleagues, legal teams, and clients also helps ensure claims are processed efficiently and fairly.

What is the difference between Adjustment Specialist vs Claims Adjuster?

AspectAdjustment SpecialistClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require insurance licensesHigh school diploma; insurance licensing often required
Work EnvironmentOffice settings, insurance companies, or claims centersFieldwork and office settings, insurance companies, claims centers
Industry UsageInsurance, healthcare, and financial servicesInsurance industry primarily, including auto, property, and health claims

Adjustment Specialists and Claims Adjusters both work within the insurance industry, often requiring similar credentials and licenses. Adjustment Specialists typically focus on reviewing and processing claims, while Claims Adjusters investigate and settle claims, sometimes involving fieldwork. Both roles are essential for claims management but differ slightly in scope and responsibilities.

Is it hard to become an adjustment specialist?

Becoming an adjustment specialist typically requires strong communication, problem-solving skills, and knowledge of insurance claims or healthcare processes. Some positions may require relevant certifications or experience, but the entry barrier is generally moderate and depends on the employer's specific requirements.
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Adjustment Specialist jobs near you
Infographic showing various Adjustment Specialist job openings in the United States as of August 2026, with employment types broken down into 87% Full Time, 11% Part Time, and 2% Contract. Highlights an 78% Physical, 2% Hybrid, and 20% Remote job distribution.

Research & Adjustment Specialist

Anchorage, AK • On-site

First National Bank Alaska
501 - 1,000 employees
Learn more about First National Bank Alaskaexternal

$19.50/hr

Full-time

Posted 4 days ago

Job description

Research & Adjustment Specialist
Start a career with First National Bank Alaska, the *Best Place to Work in Alaska* as recognized 11 years in a row by Alaska Business magazine readers.
Join our Banking Services Support Team!
We are hiring a Research and Adjustment Specialist to research and evaluate the source, or cause, of irregularities and make appropriate adjustments, as well as act as a liaison between branch supervisors, proof, and third-party institutions.
If you are detail- and process-oriented and enjoy investigating and following-through to resolution, this could be the position for you!
Salary: $19.50/hour minimum. Job/salary offer would be commensurate with experience.
Schedule: Monday-Friday
GENERAL PURPOSE SUMMARY
Researches account and report discrepancies and makes appropriate corrections and adjustments by performing the following essential duties and responsibilities:
ESSENTIAL DUTIES AND RESPONSIBILITIES
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  1. Reviews completed transactions from proof, other areas in the bank and other financial institutions; researches and evaluates source and/or causes of irregularities; and makes appropriate adjustments internally, and to external sources. Acts as liaison between branch supervisors, proof, and third party institutions.
  2. Reviews daily image reports identifying exception items and other image related discrepancies, and reports findings to supervisor.
  3. Responds to requests for account information and verifications of deposit.
  4. Prepares transit checks, adjustments, return documents, and reports.
  5. Maintains accurate and complete files with documentation of research conducted and adjustments made, including all necessary supporting documentation and images.
  6. Processes bank-to-bank collection items.
  7. Produces records for internal and external records requests.
  8. Performs other work-related duties as assigned by supervisor.
COMPLIANCE EXPECTATIONS
  • Stay updated on relevant laws and regulations and complete all compliance training on time.
  • Knowledgeable of and comply with bank policies, procedures, laws, and regulations that apply to you and your job.
  • Maintain customer confidence and protect the bank's operations by identifying and protecting confidential information.
QUALIFICATION REQUIREMENTS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
EDUCATION and/or EXPERIENCE:
Minimum: Two years related banking experience; or one year related banking experience and one year accounting related experience, education or training; or equivalent combination of education/training and experience.
Preferred: Customer service experience.
OTHER SKILLS and ABILITIES:
Word processing, spreadsheet, E-mail and Internet experience required. Ability to keyboard 35 wpm and operate a microfilm and microfiche reader/printer, copier, fax machine, and 10-key calculator by sight or touch preferred. Ability to handle highly confidential information.
LANGUAGE SKILLS:
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
MATHEMATICAL SKILLS:
Ability to calculate figures by adding and subtracting debits and credits. Ability to apply concepts of basic algebra and geometry.
REASONING SKILLS:
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms. The employee is frequently required to talk and hear. The employee is occasionally required to stand; walk; stoop, kneel, crouch, or crawl.
The employee must frequently lift and/or move up to 25 pounds. Specific vision ability required by this job includes close vision, distance vision, color vision, and the ability to adjust focus.
WORKING CONDITIONS
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
While performing the duties of this job, the employee may occasionally be exposed to work near moving mechanical parts.
The noise level in the work environment is usually moderate.

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