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Assistant Claims Examiner Jobs (NOW HIRING)

Sigma Systems, Inc.

Claims Examiner

Irving, TX

The Claims Examiner Senior is responsible for reviewing, analyzing, researching, and resolving ... Serves as a resource to assist with training new associates, retraining current associates on new ...

Aston Carter

Claims Examiner

Naperville, IL · On-site +1

$20/hr

Job Title: Claims Examiner This role entails the review, investigation, evaluation, and ... Manage the reconciliation of Customer Preferred Pricing transactions. * Assist with inquiries ...

New

MetroPlusHealth

Claims Examiner II

Manhattan, NY · On-site

$54K - $64K/yr

Audit work of assigned claims examiners to ensure accuracy ... Identify policies of common errors requiring retaining sessions * Assist with retraining sessions ...

Western Growers

Claims Examiner I

Fresno, CA · On-site +1

$40K - $52K/yr

Claims Examiner I is responsible for reviewing and processing medical, dental, vision, and ... The position will assist in resolving issues from providers, customer service, member services ...

MetroPlusHealth

Claims Examiner II

Manhattan, NY · Hybrid

$54K - $64K/yr

Audit work of assigned claims examiners to ensure accuracy ... Identify policies of common errors requiring retaining sessions * Assist with retraining sessions ...

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How much do assistant claims examiner jobs pay per hour?

As of Jul 29, 2026, the average hourly pay for assistant claims examiner in the United States is $21.05, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $22.84 per hour, depending on experience, location, and employer.

What are Assistant Claims Examiners?

Assistant Claims Examiners are entry-level professionals in the insurance industry who help process and review insurance claims. They support senior claims examiners by gathering information, verifying claim details, and ensuring that all documentation is complete and accurate. Their role is crucial in determining the validity of claims and assisting in the decision-making process regarding claim approval or denial. Assistant Claims Examiners often interact with policyholders, healthcare providers, and other stakeholders to collect necessary information. They also help maintain records and ensure compliance with company policies and regulatory requirements.

What are the key skills and qualifications needed to thrive as an Assistant Claims Examiner, and why are they important?

To thrive as an Assistant Claims Examiner, you need strong analytical abilities, attention to detail, and a foundational knowledge of insurance principles, often supported by a relevant associate degree or coursework. Familiarity with claims management software, databases, and document imaging systems is typically required. Excellent communication, organizational skills, and a customer service mindset help you collaborate effectively and handle sensitive information. These skills and qualities are crucial for accurately processing claims, minimizing errors, and ensuring customer satisfaction.

What are some common challenges faced by Assistant Claims Examiners, and how can I prepare for them?

Assistant Claims Examiners often encounter challenges such as managing a high volume of claims, ensuring accuracy under tight deadlines, and interpreting complex policy language. To prepare, it’s helpful to develop strong organizational skills, attention to detail, and resilience when working under pressure. Familiarity with claims management software and continuous learning about industry regulations will also help you navigate these challenges and contribute effectively to your team.
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What cities are hiring for Assistant Claims Examiner jobs? Cities with the most Assistant Claims Examiner job openings:
What are the most commonly searched types of Claims Examiner jobs? The most popular types of Claims Examiner jobs are:
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Assistant Claims Examiner jobs near you
Infographic showing various Assistant Claims Examiner job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 76% Full Time, 20% Part Time, 1% Temporary, and 2% Contract. Highlights an 98% Physical, 1% Hybrid, and 1% Remote job distribution, with an average salary of $43,783 per year, or $21 per hour.

Claims Examiner

Sigma Systems, Inc.

Irving, TX

Contractor

Re-posted 17 days ago

Job description

9151476 - Claims Examiner Irving, TX 3 Months contract
Sigma Inc. is currently looking for a Claims Examiner in Irving, TX.
Shift Timings: Work Schedule: 5 Days - 8 Hours
Summary:

  • The Claims Examiner Senior is responsible for reviewing, analyzing, researching, and resolving complex medical claims in accordance with claims processing guidelines and desktops, as well as, ensuring compliance with federal regulations.
  • This role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing.

Responsibilities:

  • Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
  • Analyze medical claim information and take appropriate action for payment resolution in accordance with policies and procedures, desktops, processing guidelines, and federal regulations.
  • Process medical claims submitted on CMS-1500 and CMS-1450/UB-04 claim forms from facilities, physicians, Home Health, Durable Medical Equipment providers, laboratories, etc.
  • Work claim projects resulting from overpayments or underpayments related to manual processing errors, benefit updates, and/or contract, fee schedule changes.
  • Process provider refunds, reconsiderations, and direct member reimbursements.
  • Process medical claim adjustments, recovery of claim overpayments, and execution of claim batch adjudication.
  • Solve moderately complex claims and escalate issues to the Claims Team Lead, Supervisor or Manager.
  • Assist with database improvements and testing for system upgrades, conversions, or implementation of new processes.
  • Serves as a resource to assist with training new associates, retraining current associates on new/updated desktops/policies and reports staff progress, deficiencies, and training needs to management.
  • Sets high standards of performance and promotes teamwork to achieve established team goals, while maintaining a positive, professional attitude.
  • Contacting/responding to internal and external customers for resolution on claim issues.
  • Assist claims leadership to identify claim trends, gaps in workflow and create/update desktops and policies and procedures.
  • Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals.
  • Must be able to organize and prioritize work to meet deadlines.
  • Have good judgment, initiative, and problem-solving abilities.
  • Attention to detail is critical to ensure timely and accurate processing of claims.
  • Consistently meet established productivity and quality standards.
  • Follow CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent, or detect unauthorized disclosure of Protected Health Information (PHI).
  • Performs other duties as assigned by management to support claims functions, which are focused on achieving both departmental and organizational objectives.
  • Must be knowledgeable about medical terminology, CPT, HCPCS, ICD-10, Revenue Codes, CMS-1500 and CMS-1450/UB-04 claim forms and reimbursement methodologies.
  • Must have excellent written, verbal, organizational and interpersonal communication skills.
  • Must be proficient in Microsoft Office, Power Point, Excel, Word, Outlook, spreadsheet, and database skills.


Job Requirements:

  • Associate's degree or equivalent job-related experience required.
  • Minimum of 3 years' experience processing medical claims in the healthcare industry.
  • Prior experience working with managed care, Medicare, Medicare Advantage, Health Exchange, and TRICARE are highly desirable.