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Billing Adjudicator Jobs (NOW HIRING)

ceiwc

Medical Billing Adjudicator

Towson, MD

$17.50 - $22.50/hr

Processes medical, specialty vendor bills and reimbursements to claimants in following the Workers' Compensation Commission Fee Guide or Chesapeake Employers contracted pricing in accordance with ...

Independent Health

Claims Adjudicator

Buffalo, NY · On-site

$18/hr

Knowledge of medical billing procedures; CPT and ICD-9 coding and medical terminology knowledge ... claims adjudication. * Analyze, identify and research, as needed, edits which demonstrate ...

New

NaphCare

Senior Claims Adjudicator

Birmingham, AL · On-site

Senior Claims Adjudicator Location US-AL-Birmingham ID 2026-30871 Category Accounting/Finance ... Working knowledge of medical terminology, billing standards, and Medicare and Medicaid ...

NaphCare

Senior Claims Adjudicator

Birmingham, AL

Overview NaphCare is hiring an experienced Senior Claims Adjudicator just like you to join our team ... Working knowledge of medical terminology, billing standards, and Medicare and Medicaid ...

NaphCare

Senior Claims Adjudicator

Vestavia Hills, AL · On-site

Overview NaphCare is hiring an experienced Senior Claims Adjudicator just like you to join our team ... Working knowledge of medical terminology, billing standards, and Medicare and Medicaid ...

Agape Network Inc

RCM Specialist

Miami, FL

Perform ongoing audits on Billing Queues to establish clean claim billing/adjudication * Responsible for timely re-submission and accuracy for billing claims. * Reviews claim elements as ...

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How much do billing adjudicator jobs pay per hour?

As of Jul 13, 2026, the average hourly pay for billing adjudicator in the United States is $20.79, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $21.88 per hour, depending on experience, location, and employer.

How much do adjudicators get paid?

Billing adjudicators typically earn between $35,000 and $60,000 annually, depending on experience, location, and the employer. Entry-level positions may start lower, while experienced professionals or those in specialized environments can earn higher salaries. Compensation often includes benefits such as health insurance and paid time off.

What are the key skills and qualifications needed to thrive as a Billing Adjudicator, and why are they important?

To thrive as a Billing Adjudicator, you need strong analytical skills, attention to detail, and knowledge of medical billing and insurance claims processes, often supported by an associate degree or relevant certification. Familiarity with claims management software, electronic health record (EHR) systems, and coding standards like ICD-10 and CPT is typically required. Excellent communication, problem-solving abilities, and organizational skills help address discrepancies and interact effectively with providers and insurers. These competencies ensure accurate claims processing, reduce errors, and facilitate timely reimbursement within healthcare or insurance organizations.

What are Billing Adjudicators?

Billing Adjudicators are professionals responsible for reviewing, evaluating, and processing insurance claims or billing disputes in healthcare, insurance, or related fields. They analyze submitted claims for accuracy, verify eligibility, ensure compliance with relevant policies, and determine the appropriate payment or denial. Their role helps ensure that payments are made correctly and in accordance with regulations and contractual agreements. Billing Adjudicators often work closely with healthcare providers, insurance companies, and patients to resolve billing issues.

Do adjudicators get paid?

Billing adjudicators are paid employees who receive a salary or hourly wage for their work. Compensation varies depending on the employer, location, and experience, and may include benefits such as health insurance and paid time off. They typically work regular hours and may need to complete specific training or certifications related to billing and claims processing.

Is billing clerk entry level?

A billing clerk is typically an entry-level position that involves basic data entry, invoice processing, and record keeping. Most employers require a high school diploma or equivalent, and some roles may prefer familiarity with billing software or basic accounting skills.

What is an adjudicator in medical billing?

A billing adjudicator is a professional who reviews and processes insurance claims to determine their validity and appropriate reimbursement. They analyze submitted documentation, verify coverage, and ensure compliance with billing policies, often using specialized software. This role requires attention to detail and knowledge of medical coding and insurance regulations.

What are some common challenges a Billing Adjudicator faces when reviewing and processing claims?

A Billing Adjudicator often encounters challenges such as interpreting complex insurance policies, identifying discrepancies in claims data, and ensuring compliance with ever-changing regulations. Staying updated on the latest payer guidelines and efficiently handling large volumes of claims while maintaining accuracy can also be demanding. Collaboration with other departments, such as coding and compliance teams, is essential to resolve claim discrepancies and improve workflow. Strong attention to detail and effective communication skills are key to overcoming these challenges.

What is the difference between Billing Adjudicator vs Claims Processor?

AspectBilling AdjudicatorClaims Processor
CredentialsTypically requires insurance or healthcare billing certificationsOften requires similar certifications, such as medical billing or claims processing
Work EnvironmentHealthcare or insurance companies, hospitals, or clinicsInsurance companies, healthcare providers, or third-party claims organizations
Job FocusReviewing and validating billing claims for accuracy and complianceProcessing and adjudicating insurance claims for payment

The main difference between a Billing Adjudicator and a Claims Processor lies in their focus: Billing Adjudicators primarily review and validate billing claims for accuracy, while Claims Processors handle the initial processing and adjudication of insurance claims. Both roles require similar certifications and are found in healthcare and insurance settings, but their specific responsibilities differ slightly.

More about Billing Adjudicator jobs
What job categories do people searching Billing Adjudicator jobs look for? The top searched job categories for Billing Adjudicator jobs are:
Billing Adjudicator jobs near you
Infographic showing various Billing Adjudicator job openings in the United States as of July 2026, with employment types broken down into 2% Locum Tenens, 4% Internship, 88% As Needed, 3% Full Time, and 3% Nights. Highlights an 85% Physical, 1% Hybrid, and 14% Remote job distribution, with an average salary of $43,233 per year, or $20.8 per hour.

Medical Billing Adjudicator

ceiwc

Towson, MD

$17.50 - $22.50/hr

Other

Posted 17 days ago

Job description

POSITION SUMMARY:

Processes medical, specialty vendor bills and reimbursements to claimants in following the Workers’ Compensation Commission Fee Guide or Chesapeake Employers contracted pricing in accordance with established Chesapeake policies and procedures. Serves as a resource for training and assists team leads in daily operational activities.

DUTIES AND RESPONSIBILITIES:

• Performs data entry of bills submitted for processing by accurately recording the required information into the correct fields in WCIS.
• Processes physicians bills.
• Determines if charges are related to accepted claim through knowledge of medical diagnostic coding and review of accepted body parts. Denies unrelated bills or charges.
• Processes bills submitted for medical treatment in accordance with established Chesapeake policies and the WC Fee Guide.
• Reviews the claims notepad for authorizations and notes regarding billing issues as indicated. Uses judgement in referring bills to adjusters if further investigation is warranted.
• Accepts or denies charges while selecting appropriate reason codes.
• Responds to inquiries from claimants, medical providers and company personnel regarding the payment, denial of payment or clarification required for completion of processing.
• Meets departmental guidelines for productivity and accuracy of processing of medical bills.
• Attends web-based training to develop in-depth knowledge in specific specialty areas to maintain industry standard practices.
• Assists coders in resolving consideration requests as needed.
• Assists with quality audits.

SKILLS, EDUCATION AND EXPERIENCE:

• A High School Diploma or equivalent is required.
• 2-3 years’ experience in bill processing.
• PC skills including Excel familiarity.
• Excellent communication skills, both verbal and written.
• ICD-9, ICD-10 and CPT coding knowledge.
• Medical terminology familiarity.
• Bilingual skills preferred.
• CPC preferred. CPC will be required within 3 years of employment.

POSITIONAL COMPETENCIES:

• Bias for Action
• Knowledge Sharing
• Deliver Results
• Service and Sales Excellence
• Personal Leadership
• Teamwork and Communication

PHYSICAL DEMANDS:

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 occasionally required to stand, walk, stoop, kneel, crouch or crawl. The employee may occasionally lift up to 30 pounds. Specific vision abilities are required, which include close vision, peripheral vision and the ability to adjust focus.

WORK ENVIRONMENT:

Office Environment. The noise level is usually moderate.

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