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$14

$49

$79

How much do claims consultant jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for claims consultant in the United States is $49.12, according to ZipRecruiter salary data. Most workers in this role earn between $32.69 and $67.31 per hour, depending on experience, location, and employer.

What is a claims consultant?

A claims consultant is an insurance claims adjuster that helps protect their employers from insurance fraud. As a claims consultant, you perform the typical job duties of a claims adjuster while also conducting specialized investigations on complicated insurance cases. You may be called upon to give court testimony in cases that involve insurance liability and loss. You must receive specialized training to learn the skills necessary to analyze these complex insurance cases. Claims consultants work closely with management, legal teams, and clients, so experience with collaborative investigation is crucial. Additional qualifications include a degree in forensic accounting or a related field.

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

To thrive as a Claims Consultant, you typically need expertise in insurance policies, risk assessment, and claims management, often supported by a relevant degree or industry certification (such as ANZIIF or CPCU). Familiarity with claims management systems, policy administration software, and regulatory compliance tools is essential. Strong analytical thinking, negotiation abilities, and effective communication skills help build trust with clients and resolve complex claims efficiently. These skills and qualities are crucial for ensuring fair claims outcomes, maintaining client satisfaction, and upholding the company's reputation.

What are some common challenges faced by claims consultants, and how can they be managed effectively?

Claims Consultants often navigate complex cases that require balancing client expectations, insurer guidelines, and regulatory compliance. A frequent challenge is managing high caseloads while ensuring thorough documentation and timely communication with all stakeholders. To manage these effectively, strong organizational skills, clear communication, and staying current with industry regulations are essential. Collaborating closely with legal teams and adjusters can also help resolve disputes efficiently and maintain positive client relationships.

What is the difference between Claims Consultant vs Claims Adjuster?

AspectClaims ConsultantClaims Adjuster
CredentialsTypically requires industry certifications like CPCU or ARMOften requires similar certifications, such as CPCU or state licensing
Work EnvironmentAdvises clients and insurers, often in an office or remote settingInvestigates and evaluates claims, usually in the field or office
Employer & Industry UsageInsurance firms, consulting companies, brokersInsurance companies, third-party administrators
Common Search & ComparisonYesYes

While both Claims Consultants and Claims Adjusters work within the insurance industry and may hold similar certifications, Claims Consultants primarily advise clients and insurers on claims processes and strategies. Claims Adjusters focus on investigating, evaluating, and settling claims directly. The roles often overlap but differ mainly in their focus—consultants on advisory services, adjusters on claim resolution.

Is insurance claims a stressful job?

Claims consultants often handle complex cases that require attention to detail and strong communication skills, which can be stressful during high workload periods or when dealing with difficult clients. The job may involve tight deadlines and emotional situations, but stress levels vary depending on the employer, workload, and individual coping strategies.
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Claims Consultant jobs near you
Infographic showing various Claims Consultant job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 89% Full Time, 6% Part Time, and 4% Contract. Highlights an 71% Physical, 3% Hybrid, and 26% Remote job distribution, with an average salary of $102,175 per year, or $49.1 per hour.

Claims Consultant

Tata Consultancy Service Limited

Tampa, FL • On-site

$48K - $55K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 26 days ago

Job description

Responsibilities:
To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments.
Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or continuous)
Review and analyze medical information (i.e. attending physician reports, medical records such as diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined.
Approval or denial on FMLA claims as per Insurance carrier, and employers guidelines
Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to US paid family law regulations.
Review claims for Not in good order cases, and work on securing missing documentations including employee, physician, or employer outreach.
Communicates clearly with the claimants and clients to set expectations on all aspects of claims process either by phone and/or written correspondence.
Reviews client critical deliverables, manages the overall workload, and second-level process escalation.
Determines benefits due, makes timely claims payments/approvals and adjustments for Workers Compensation, State Short Term Disability, and other disability offsets.
Refers cases as appropriate to team lead and clinical case management
Responsible for managing the day-to-day workload and first-level process escalation, and reviews processes for accuracy and timeliness where applicable in case of peer reviews.
Provide ideas to management on continuous improvement and service level management
Performs other duties or participates in special projects as assigned
Requirements:
1+ year of Disability/FMLA/PFL claims or insurance claims experience
Experience working with FINEOS
Working knowledge of medical terminology and documents, including APS, Diagnostic Tests, Imaging Tests reports
Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices mandatory
Excellent oral and written communication, including presentation skills
Strong Analytical, decision making, problem solving, and people management skills
Computer experience with keyboarding skills and proficiency in using software applications and packages including MS Office (Excel, Word, PPT)
Willingness to embrace change in a fast paced work environment
A strong desire to continuously learn and improve
Identify escalated cases and work with Team Leader to develop a plan to address key issues.
TCS Employee Benefits Summary:
• Discretionary Annual Incentive.
• Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.
• Family Support: Maternal & Parental Leaves.
• Insurance Options: Auto & Home Insurance, Identity Theft Protection.
• Convenience & Professional Growth: Commuter Benefits & Certification & Training Reimbursement.
• Time Off: Vacation, Time Off, Sick Leave & Holidays.
• Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.
Salary Ran ge: $48,000 - $55,000 per year

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