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Associate Claims Examiner Jobs (NOW HIRING)

Adecco

Medical Claims Examiner

San Antonio, TX

$22.50/hr

Claims Examiner - San Antonio, TX ($22.50/hr, Mon-Fri 8am-5pm) Adecco is hiring a Claims Examiner ... In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other ...

MetroPlusHealth

Claims Examiner I

Manhattan, NY · Hybrid

$50K - $54K/yr

Position Overview The Claims Examiner I is responsible for the data entry and system adjudication ... Associate's Degree required; and * Minimum 2 years' experience in the healthcare insurance industry ...

New

Wellcove

Claims - Claims Examiner

Pensacola, FL · On-site

We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. The Long-Term Care (LTC) Claims Examiner is responsible for the accurate and timely ...

MetroPlusHealth

Claims Examiner I

Manhattan, NY · On-site

$50K - $54K/yr

Position Overview The Claims Examiner I is responsible for the data entry and system adjudication ... Associate's Degree required; and * Minimum 2 years' experience in the healthcare insurance industry ...

New

Point C

Claims Examiner

$19 - $22/hr

Point C is looking for a detail-oriented and motivated Claims Examiner to join our team. In this ... Associate Degree Preferred Individual compensation will be commensurate with the candidate ...

New

Point C

Claims Examiner

Bellingham, WA · On-site

$19 - $22/hr

Point C is looking for a detail-oriented and motivated Claims Examiner to join our team. In this ... Associate Degree Preferred Individual compensation will be commensurate with the candidate ...

Point C

OR · On-site

Point C is looking for a detail-oriented and motivated Claims Examinerto join our team. In this ... Associate Degree Preferred

New

Securian Financial

Claims Examiner

Macon, GA · On-site

$18.80 - $32.69/hr

Associates get the benefit of working both virtually and in our offices. If you're in a commutable ... Business, Claims Processing, Communication, Payment Processing, Problem Solving, Standard Operating ...

Securian Financial

Claims Examiner

Macon, GA · Hybrid

$18.80 - $32.69/hr

Associates get the benefit of working both virtually and in our offices. If you're in a commutable ... Business, Claims Processing, Communication, Payment Processing, Problem Solving, Standard Operating ...

Adecco

Medical Claims Examiner

San Antonio, TX

$22.50/hr

Monday-Friday, 8:00 AM - 5:00 PM (Onsite) Adecco is seeking a detail-oriented Claims Examiner to ... In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other ...

Adecco

Medical Claims Examiner

San Antonio, TX

$22.50/hr

Monday-Friday, 8:00 AM - 5:00 PM (Onsite) Adecco is seeking a detail-oriented Claims Examiner to ... In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other ...

Safepoint MGA, LLC

Sr. Claims Examiner

Tampa, FL · On-site

Job Summary The Senior Claims Examiner is a remote position responsible for handling daily ... Associate's degree minimum; Bachelor's degree preferred; or an equivalent combination of education ...

Adecco

Medical Claims Examiner

San Antonio, TX

$22.50/hr

Monday-Friday, 8:00 AM - 5:00 PM (Onsite) Adecco is seeking a detail-oriented Claims Examiner to ... In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other ...

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Associate Claims Examiner information

See salary details

$15

$29

$45

How much do associate claims examiner jobs pay per hour?

As of Jul 16, 2026, the average hourly pay for associate claims examiner in the United States is $29.40, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $35.10 per hour, depending on experience, location, and employer.

What is the difference between Associate Claims Examiner vs Claims Adjuster?

AspectAssociate Claims ExaminerClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may prefer insurance certificationsHigh school diploma or equivalent; licensing or certification may be required depending on state
Work EnvironmentOffice setting, analyzing claims, reviewing documentationField or office, investigating claims, inspecting damages
Employer & IndustryInsurance companies, government agenciesInsurance companies, third-party administrators
Common Search & ComparisonYesYes

The Associate Claims Examiner and Claims Adjuster roles both involve handling insurance claims, but they differ mainly in work environment and responsibilities. The Associate Claims Examiner typically works in an office reviewing claims and documentation, while the Claims Adjuster may investigate damages in the field. Both roles require similar basic credentials, but licensing may be more common for Claims Adjusters. Understanding these differences helps job seekers find the right position in the insurance industry.

What are some common challenges faced by an Associate Claims Examiner, and how are they typically addressed?

Associate Claims Examiners often encounter challenges such as balancing high caseloads, interpreting complex policy language, and meeting tight deadlines. To address these, most organizations provide comprehensive training, access to experienced mentors, and digital tools to streamline the claims review process. Working closely with senior examiners and collaborating with other departments, such as customer service or legal teams, also helps in resolving uncertainties and ensuring timely, accurate claim decisions.

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

To thrive as an Associate Claims Examiner, you need a solid understanding of insurance policies, claims processing, and attention to detail, typically supported by a bachelor’s degree or relevant experience. Familiarity with claims management software and knowledge of regulatory compliance standards are essential technical requirements. Strong analytical thinking, effective communication, and organizational skills help you excel in investigating and resolving claims efficiently. These competencies ensure accurate claims assessment, regulatory adherence, and timely service for clients.

What are Associate Claims Examiners?

Associate Claims Examiners are entry-level professionals who review insurance claims to determine their validity and ensure they comply with company policies and legal requirements. They gather and analyze information, communicate with policyholders, and work with other departments to process claims efficiently. Their role often involves investigating details, verifying documentation, and recommending claim approvals or denials based on their findings. Associate Claims Examiners play a key part in helping insurance companies manage risk and provide quality customer service.
What cities are hiring for Associate Claims Examiner jobs? Cities with the most Associate Claims Examiner job openings:
What are the most commonly searched types of Claims Examiner jobs? The most popular types of Claims Examiner jobs are:
What states have the most Associate Claims Examiner jobs? States with the most job openings for Associate Claims Examiner jobs include:
Associate Claims Examiner jobs near you
Claims Examiner

Claims Examiner

Advanced Medical Pricing Solutions

Phoenix, AZ • On-site

Other

Medical, Dental, Vision

Posted 29 days ago

Job description

Description

The Claims Examiner properly applies plan/guidelines provisions. This position is responsible for processing medical, dental and vision claims, and answers questions in accordance with relevant terms and established procedure. This position works closely with other departments to proactively research concerns and resolve to the satisfaction of the client. This position will handle complex claims issues, assist with team workflow management and any special projects as assigned. This position maintains a comprehensive understanding of the plan document(s)/guidelines under their scope of responsibility.


Essential Job Duties:

  • Maintain HIPAA/PII guidelines to ensure the confidentiality of all calls and documents
  • Claims Processing
  • Interpret plan documents/guidelines
  • Determine eligibility by reviewing, researching and analyzing information
  • Process, deny, allow or pend claims
  • Manage a moderate volume and complexity of groups and members
  • Use critical thinking and reasoning to manage workload with above average level of financial risk
  • Provide training to new and assigned employees
  • Correspondence
  • Maintain and enter information into system as information is received
  • Forward all records to the appropriate parties
  • Group Contacts
  • Record and respond to calls/e-mails from Groups
  • Maintain high level of knowledge to answer specific plan/guideline and claim questions
  • Establish relationships with Team Members for each group
  • Review issues as they arise
  • Appeals and Inquiries
  • Note system when appeals and inquiries are established 
  • Record all information on appeals and inquiries in the database
  • Note in system if claim is going to a committee or to outside review
  • Customer Service
  • Serve as a role model in demonstrating core values of customer service
  • Provide timely and thorough responses to internal and external customers
  • Respond to member and group correspondences regarding plan/guideline or claim questions within 24 hours
  • Escalate difficult issues to the appropriate chain of command
  • Quality Assurance
  • Ensure compliance with service standards
  • Follow trends within assigned scope and alert appropriate parties of any that fall outside quality parameters
  • Develop and execute plans to meet established goals 
  • Provide continuous feedback to strengthen and optimize quality performance
  • Work cross-departmentally to improve or streamline procedures
  • Maintain up to date knowledge on industry trends and look for new data sources
  • Develop or improve current internal processes to improve overall quality 
  • Special projects as assigned

Skills/Abilities:


  • Excellent verbal and written communication skills with high attention to detail
  • Excellent customer service skills 
  • Strong analytical and problem-solving skills
  • Confident decision-making abilities
  • Demonstrated ability to work independently, prioritize workloads and manage priorities to meet deadlines

Requirements

Education/Experience:


  • High school diploma or equivalent required
  • Associates degree in Medical Billing and Coding or related field preferred
  • 2 -5 years of Claims Examiner experience or equivalent required
  •  Javelina a huge plus 
  • Knowledge of medical terminology preferred

Physical Requirements:


  • Indoor office environment with moderate noise
  • Intermittent physical effort may include lifting up to 25 lbs., walking, stopping, kneeling, crouching or crawling may be required
  • Frequent sitting, use of a keyboard, reaching with hands and arms, talking and hearing approximately 70% of the time; 30% or less time is spent standing
  • Normal vision abilities required including close vision and ability to adjust focus 

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