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Billing Adjudicator Jobs (NOW HIRING)

AKUDO HEALTHCARE

Be Seen First

PHARMACY BILLING SPECIALIST

Austell, GA · Remote

$17 - $20/hr

We are seeking an experienced Pharmacy Billing Specialist to manage prescription claim processing, insurance adjudication, PA, claim rejection, collection, and revenue cycle support within a fast ...

AmeriPharma

Claims Adjudicator

Laguna Hills, CA · On-site

Stay informed on current billing issues and implement necessary changes to existing billing ... Adhere to the 14-day adjudication and scheduled delivery window. * Promptly report underpaid claims ...

AmeriPharma

Claims Adjudicator

Laguna Hills, CA

Stay informed on current billing issues and implement necessary changes to existing billing ... Adhere to the 14-day adjudication and scheduled delivery window. * Promptly report underpaid claims ...

AmeriPharma

Claims Adjudicator

Laguna Hills, CA · On-site

$29 - $32/hr

Stay informed on current billing issues and implement necessary changes to existing billing ... Adhere to the 14-day adjudication and scheduled delivery window. * Promptly report underpaid claims ...

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 ...

WellSense Health Plan

Claims Adjudicator

$18.27 - $25.72/hr

... adjudication. · Alerts claims management to claims aging issues as well as provider ... billing problems. · Maintains current knowledge of company members' benefits, policies/procedures ...

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Billing Adjudicator information

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How much do billing adjudicator jobs pay per hour?

As of Jun 12, 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 an average salary ranging from $40,000 to $60,000 per year, depending on experience, location, and employer. Entry-level positions may start lower, while experienced adjudicators with specialized knowledge can earn higher wages, often supplemented with benefits and opportunities for advancement.

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 job makes $10,000 a month without a degree?

A Billing Adjudicator typically earns between $3,000 and $6,000 per month, so earning $10,000 monthly without a degree is uncommon in this role. High-paying jobs that can reach this level often involve specialized skills, certifications, or experience in fields like sales, real estate, or entrepreneurship. Some self-employed or commission-based roles may also achieve this income without formal degrees.

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 typically paid a salary or hourly wage for their work, which involves reviewing and processing insurance claims or billing disputes. Compensation varies based on experience, location, and employer, and may include benefits such as health insurance and paid time off.

What jobs pay 2000 a day?

A Billing Adjudicator typically does not earn $2000 a day; such high daily earnings are more common in specialized roles like senior executives, high-level consultants, or certain medical professionals. Most billing adjudicators earn an annual salary that reflects their experience and industry standards, usually far below this daily rate. High-paying roles often require advanced certifications, extensive experience, or working in lucrative industries such as finance or healthcare consulting.

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 June 2026, with employment types broken down into 1% As Needed, 88% Full Time, and 11% Part Time. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $43,233 per year, or $20.8 per hour.

PHARMACY BILLING SPECIALIST

AKUDO HEALTHCARE

Austell, GA • Remote

$17 - $20/hr

Contractor

Posted 19 days ago

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Job description

We are seeking an experienced Pharmacy Billing Specialist to manage prescription claim processing, insurance adjudication, PA, claim rejection, collection, and revenue cycle support within a fast-paced long-term care (LTC) pharmacy.

This role is critical to ensuring timely reimbursement, clean claim submission, and resolution of rejected claims across multiple nursing facilities

Key Responsibilities

Prescription Billing & Adjudication

  • Submit and process prescription claims through pharmacy software (e.g., BestRx)
  • Ensure accurate entry of patient demographics, insurance, and prescription data
  • Monitor claim status and ensure successful adjudication in real-time

Rejection Resolution & Follow-Up

  • Analyze and resolve rejected/denied claims (e.g., prior auth, refill too soon, coverage issues)
  • Communicate with insurance companies, prescribers, and facilities to resolve issues
  • Track and follow up on outstanding claims to ensure reimbursement

Prior Authorizations & Documentation

  • Initiate and manage prior authorization (PA) requests
  • Collect required clinical documentation from providers
  • Maintain detailed records of PA status and outcomes

LTC Facility Coordination

  • Work directly with nursing homes and facility staff to resolve billing discrepancies
  • Verify census updates, patient eligibility, and insurance changes
  • Support cycle fill billing and recurring medication processing

Revenue Cycle & Compliance

  • Maintain clean billing queues and minimize aging claims
  • Assist in reconciling unpaid claims and identifying revenue leakage
  • Ensure compliance with pharmacy billing regulations and audit standards

Required Qualifications

  • Pharmacy Technician experience (preferred or required depending on your preference)
  • Proven experience with pharmacy billing and insurance adjudication
  • Familiarity with pharmacy systems (BestRx strongly preferred)
  • Strong understanding of:
    • Medicare Part D / Medicaid billing
    • Third-party insurance claims
    • Rejection codes and resolution workflows
  • Preferred Qualifications
  • Long-Term Care (LTC) pharmacy experience
  • Experience with high-volume prescription environments
  • Knowledge of cycle fills and MAR coordination

⚙️ Core Competencies

  • High attention to detail (critical for claim accuracy)
  • Strong problem-solving (rejection resolution)
  • Ability to multitask in a high-volume workflow
  • Clear communication with facilities and providers

Company Description

We are a closed‐door long‐term care pharmacy proudly serving our community for more than 15 years. As a family‐friendly organization, we value teamwork, respect, and a supportive work culture. Our environment is collaborative, mission‐driven, and rooted in the belief that exceptional patient care begins with a strong, supported team.
We understand that life happens, and we are committed to offering schedule flexibility when needed. Our goal is to create a workplace where employees feel valued, balanced, and empowered to grow.