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Claim Reviewer Jobs (NOW HIRING)

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IDR Nurse Reviewer

Virginia Beach, VA · On-site

$45 - $55/hr

The Nurse Reviewer position is responsible for supporting and conducting reviews and determinations ... This position will be responsible for resolving claim disputes submitted by various parties, such ...

Village Capital & Investment

VA Claim Processor

Hildale, UT · On-site

$13.75 - $17.50/hr

Review and process claims in accordance with VA guideline, ensuring that all information is ... Claim Review: Verify and review property and loan information to ensure eligibility for Liquidation ...

MSIG Holdings USA, Inc.

Claim Account Executive

Warren, NJ · On-site +1

$150K - $180K/yr

Coordinate claim reviews, large loss discussions, and issue resolution with adjusters, litigation teams, and internal partners. * Monitor adherence to service commitments and escalate issues ...

Empower AI Inc.

Reviews and completes referred level claim reviews in accordance to production standards for special studies as well as regular project claims for end of reporting requirements * Assists with ...

Empower AI Inc.

Reviews and completes referred level claim reviews in accordance to production standards for special studies as well as regular project claims for end of reporting requirements * Assists with ...

MedReview

DRG Reviewer

Manhattan, NY · Remote

Maintains 95% accuracy in claim reviews. * Must be available to work a 7.5-hour workday during Eastern Standard Time (EST) business hours. * Comply with organization policy and procedures.

MedReview

DRG Reviewer

Manhattan, NY · On-site +1

$85K - $90K/yr

Maintains 95% accuracy in claim reviews. * Must be available to work a 7.5-hour workday during Eastern Standard Time (EST) business hours. * Comply with organization policy and procedures.

Zelis

Clinical Nurse Reviewer

Saint Petersburg, FL

Conduct prompt claim review to support internal inventory management to achieve greatest possible savings for clients. What You'll Do: * Conduct routine reviews of medical records and supporting ...

Zelis

Clinical Nurse Reviewer

Saint Petersburg, FL · On-site

Conduct prompt claim review to support internal inventory management to achieve greatest possible savings for clients. What You'll Do: * Conduct routine reviews of medical records and supporting ...

Chubb

Lost Time Senior Claim Examiner

New Haven, CT · On-site

$33 - $44.75/hr

Reviews claim and policy information to provide background for the investigation * Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with the insured ...

Zelis

Clinical Nurse Reviewer

Boston, MA · On-site

Conduct prompt claim review to support internal inventory management to achieve greatest possible savings for clients. What You'll Do: * Conduct routine reviews of medical records and supporting ...

Zelis

Clinical Nurse Reviewer

Saint Louis, MO · On-site

Conduct prompt claim review to support internal inventory management to achieve greatest possible savings for clients. What You'll Do: * Conduct routine reviews of medical records and supporting ...

Zelis

Clinical Nurse Reviewer

Atlanta, GA · On-site

Conduct prompt claim review to support internal inventory management to achieve greatest possible savings for clients. What You'll Do: * Conduct routine reviews of medical records and supporting ...

Zelis

Clinical Nurse Reviewer

Plano, TX · On-site

Conduct prompt claim review to support internal inventory management to achieve greatest possible savings for clients. What You'll Do: * Conduct routine reviews of medical records and supporting ...

Zelis

Clinical Nurse Reviewer

Morristown, NJ · On-site

Conduct prompt claim review to support internal inventory management to achieve greatest possible savings for clients. What You'll Do: * Conduct routine reviews of medical records and supporting ...

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How much do claim reviewer jobs pay per hour?

As of Jul 16, 2026, the average hourly pay for claim reviewer in the United States is $19.85, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $21.63 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Claim Reviewer position, and why are they important?

To thrive as a Claim Reviewer, you need a strong understanding of insurance policies, claims processing procedures, and attention to detail, often supported by relevant experience or education in insurance or a related field. Familiarity with claims management software, document imaging systems, and occasionally industry certifications (such as AIC or CPCU) are valuable assets. Strong analytical thinking, clear communication, and organizational skills help Claim Reviewers manage case loads and coordinate with different teams. Possessing these skills ensures accurate evaluations, timely processing, and maintains compliance and customer satisfaction in the claims process.

How to get a job as a claims examiner?

To become a claims examiner, candidates typically need a high school diploma or equivalent, with some roles requiring an associate's or bachelor's degree in fields like insurance, finance, or healthcare. Relevant skills include attention to detail, analytical thinking, and knowledge of insurance policies; certifications such as the Certified Claims Professional (CCP) can enhance prospects. Job opportunities are often found through online job boards, insurance companies, and government agencies, with some positions offering on-the-job training.

What is a Claim Reviewer job?

A Claim Reviewer is responsible for evaluating insurance claims to determine their validity and compliance with policy terms. They review documentation, investigate details, and assess whether claims should be approved, denied, or require further information. Claim Reviewers work closely with policyholders, healthcare providers, or other relevant parties to ensure accurate claim processing. Their role helps prevent fraud, control costs, and ensure fair payouts.

What does a typical workday look like for a Claim Reviewer?

As a Claim Reviewer, your day typically involves reviewing submitted claims to verify accuracy, completeness, and compliance with policy guidelines. You'll analyze supporting documentation, collaborate with adjusters or other team members for additional information, and ensure decisions are well-documented and justified. Expect to handle multiple cases simultaneously, requiring good time management and organizational skills. Communication with customers or policyholders may occur when clarifications or follow-ups are needed. The work is often structured yet dynamic, offering meaningful variety and opportunities to develop knowledge within the insurance industry.

Is a claims examiner a stressful job?

A claims examiner reviews insurance claims and often works under tight deadlines, which can contribute to job stress. The role requires attention to detail, decision-making skills, and sometimes handling complex or disputed claims, which may increase pressure. Overall, stress levels vary depending on workload, employer support, and individual resilience.

What does a claims reviewer do?

A claims reviewer evaluates insurance claims to determine their validity and ensure they comply with policy terms. They analyze documentation, verify information, and make decisions on claim approval or denial, often using specialized software and following company guidelines.

How to get a job as a reviewer?

To become a claim reviewer, candidates typically need a high school diploma or equivalent, with some roles requiring a bachelor's degree in a related field. Relevant skills include attention to detail, strong communication, and knowledge of insurance policies or claims processes. Gaining experience through internships or entry-level positions can improve chances, and familiarity with claims management software is often beneficial.
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Claim Reviewer jobs near you
Infographic showing various Claim Reviewer job openings in the United States as of July 2026, with employment types broken down into 81% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $41,287 per year, or $19.8 per hour.

Claim Account Executive

MSIG Holdings USA, Inc.

Warren, NJ • On-site

$150K - $180K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 8 days ago

Job description

MSIG USA continues to grow!
Company Overview:
MSIG USA is the US-based subsidiary of MS&AD Insurance Group Holdings, Inc., one of the world's top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business's unique risks.
Job Summary
The Claim Account Executive (CAE) is responsible for the execution and oversight of claims service delivery for assigned strategic and complex accounts. The role serves as the primary claims relationship owner, ensuring consistent communication, disciplined claim execution, issue resolution, and delivery of claims insights aligned to client business objectives.
Operating within MSIG's Claims-Led Modern Account Management Program, the CAE partners with Claims Leadership, Distribution Risk Managers, adjusters, litigation teams, and other internal stakeholders to deliver predictable, transparent, and value-driven claims outcomes that support client trust, retention, and long-term account performance.
Role is located in either - Atlanta, GA, Chicago, IL or Warren, NJ
Essential Duties and Responsibilities
Account Management & Client Engagement
  • Maintain a comprehensive understanding of assigned clients' business operations, risk profiles, and service expectations.
  • Serve as the primary claims contact for assigned accounts, ensuring timely, professional, and consistent communication.
  • Build and sustain effective working relationships with client risk leadership, brokers, and key stakeholders.
  • Conduct on-site visits, claim reviews, and stewardship meetings as appropriate.

Claims Service Execution
  • Execute the Claims Service Plan (Day 1 document), including special handling instructions, escalation thresholds, reporting requirements, and communication standards.
  • Coordinate claim reviews, large loss discussions, and issue resolution with adjusters, litigation teams, and internal partners.
  • Monitor adherence to service commitments and escalate issues appropriately to Claims Leadership.
  • Ensure compliance with Special Claim Instructions and participate in audits or service reviews as required.

Stewardship, Reporting & Insights
  • Prepare and present claims-led stewardship materials connecting loss activity to trends, operational drivers, and Total Cost of Risk considerations.
  • Translate claims data into actionable insights rather than transactional reporting.
  • Support renewal and pre-renewal meetings by providing claims performance narratives and issue awareness.

Cross-Functional Collaboration
  • Partner with Claims Leadership, Distribution Risk Managers, Underwriting, Risk Engineering, IT, and Finance to ensure a coordinated client experience.
  • Share client feedback, service trends, and improvement opportunities internally.
  • Support continuous improvement of account management processes and standards.

Customer Service & Professional Standards
  • Demonstrates professionalism, sound judgment, and discretion in all client interactions.
  • Responds promptly to client inquiries and service needs.
  • Manages complex or sensitive situations calmly and constructively.
  • Communicates clearly, sets realistic expectations, and follows through on commitments.
  • Maintains accurate documentation of client requests and service activity.

Qualifications/Education & Experience
  • Bachelor's degree preferred or equivalent business experience.
  • Minimum 5 years of experience in large account property & casualty insurance, including claims exposure.
  • Claims handling or claims management experience strongly preferred.
  • Professional insurance designations (e.g., CPCU) encouraged.

Knowledge & Skills
  • Strong knowledge of property & casualty claims practices, policies, and regulatory considerations.
  • Ability to interpret insurance policies, procedures, and special handling instructions.
  • Proficiency in analyzing loss data and identifying trends.
  • Strong verbal, written, and presentation skills.
  • Effective time management and organizational skills.
  • Proficiency with Microsoft Office and insurance systems.

Supervisory Responsibility
  • No direct supervisory responsibility.

Salary: the base pay range is $150,000.00 - $180,000.00. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location.
Additional Benefits:
Healthcare and Retirement Benefits
Comprehensive medical, dental, and vision coverage
401(k) with a generous employer match and profit-sharing contribution
Wellness incentive program
Life and accidental death and dismemberment (AD&D) insurance
Flexible spending programs
Short-term and long-term disability plans
Additional Benefit Programs
Paid time off program
Paid charitable leave
Paid parental leave
Tuition reimbursement program
Personal insurance (auto/homeowners) discounts
#LI-REMOTE OR #LI-HYBRID
It's an exciting time for our company and a great opportunity to join a financially sound and growing global insurance group!
It is the policy of MSIG USA to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, MSIG USA will provide reasonable accommodations for qualified individuals with disabilities.

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