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Claims Examiner 1 Jobs (NOW HIRING)

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The Claims Examiner is responsible for reviewing, evaluating, and resolving insurance claims in ... No Duties/Responsibilities: 1. Reviews reports to ensure that no errors have been made in the ...

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Diploma or GED Required 1 year claims examination experience Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We ...

Diploma or GED • Required 1 year claims examination experience About Us Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for ...

Medical Claims Examiner, Tucson, AZ The responsibilities of the Medical Claims Examiner consist of ... one month of hire, complete new-employee orientation. - Complete and provide all training as ...

High school diploma or equivalent or one to three months of related experience and/or training or ... We offer this Claims Examiner I position competitive pay . We also offer our team great benefits!

High school diploma or equivalent or one to three months of related experience and/or training or ... As a Claims Examiner I, you will analyze insurance claims of low to moderate difficulty to ...

High school diploma or equivalent or one to three months of related experience and/or training or ... We offer this Claims Examiner I position competitive pay . We also offer our team great benefits!

Medical Claims Examiner

Los Angeles, CA · On-site +1

$24 - $30/hr

General information Client / Corporate Client Work Mode Hybrid Name Medical Claims Examiner Job ID ... Apply now and help us transform lives-one claim at a time! We are an equal opportunity employer ...

As a Claims Examiner, you will be responsible for accurately reviewing, investigating, and ... At least 1-2 years of experience working closely with healthcare claims or in a claims processing ...

Position Summary We are seeking a detail-oriented Claims Examiner & Support Specialist I to support ... Minimum 1 year of call center or customer service experience preferred. Previous healthcare claims ...

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Claims Examiner 1 information

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$15

$29

$45

How much do claims examiner 1 jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for claims examiner 1 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 does a claims examiner 1 do?

A Claims Examiner 1 is responsible for reviewing insurance claims to determine their validity and ensure they comply with policy terms. They analyze documentation, investigate discrepancies, and may communicate with policyholders or other parties to gather necessary information. Their work helps prevent fraud and ensures that claim payments are accurate and justified. Typically, a Claims Examiner 1 handles straightforward cases and refers complex claims to more senior examiners.

What are the key skills and qualifications needed to thrive as a claims examiner 1, and why are they important?

To thrive as a Claims Examiner 1, you need a solid understanding of insurance policies, claims processing procedures, and attention to detail, often supported by a high school diploma or associate degree. Familiarity with claims management software, industry regulations, and basic office applications is typically required. Strong analytical skills, effective communication, and organizational abilities help resolve claims accurately and efficiently. These skills are crucial for ensuring claims are processed fairly, minimizing errors, and maintaining customer satisfaction.

What are some common challenges new claims examiners 1 might face, and how can they overcome them?

New Claims Examiners 1 often face challenges such as interpreting complex policy language, managing a high volume of claims, and balancing accuracy with efficiency. To overcome these challenges, it's helpful to familiarize yourself thoroughly with the company's policies and procedures, seek guidance from experienced colleagues, and utilize available training resources. Building strong organizational skills and maintaining clear communication with claimants and other departments can also help ensure a smoother workflow and reduce errors. Over time, these strategies contribute to increased confidence and proficiency in handling diverse claims.

What is the difference between Claims Examiner 1 vs Claims Examiner 2?

AspectClaims Examiner 1Claims Examiner 2
Required CredentialsHigh school diploma or equivalent; some roles may require certificationHigh school diploma or equivalent; some roles may require certification
Work EnvironmentOffice setting, reviewing insurance claimsOffice setting, reviewing more complex claims or higher volume
Employer & Industry UsageInsurance companies, government agenciesInsurance companies, government agencies, third-party administrators
Common Search & ComparisonYesYes

The main difference between Claims Examiner 1 and Claims Examiner 2 lies in experience level and complexity of claims handled. Claims Examiner 2 typically manages more complex cases and may require additional certifications or experience. Both roles operate in similar environments within insurance and government sectors, but Claims Examiner 2 often involves higher responsibilities and expertise.

How much do claims examiners make in the US?

Claims examiners in the US typically earn a median annual salary of around $45,000 to $55,000, with entry-level positions starting lower and experienced examiners earning higher wages. Salaries can vary based on location, experience, and the employer, and some roles may require knowledge of claims processing software and certification.

Is claims processing a stressful job?

Claims Examiner 1 roles can be stressful due to the need for accuracy, attention to detail, and meeting deadlines when reviewing and processing insurance claims. The job often involves handling complex cases and dealing with claimants' concerns, which can contribute to work-related stress, especially during high-volume periods or when resolving disputes.
More about Claims Examiner 1 jobs
Infographic showing various Claims Examiner 1 job openings in the United States as of August 2026, with employment types broken down into 90% Full Time, 8% Part Time, and 2% Contract. Highlights an 85% Physical, 4% Hybrid, and 11% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.

Claims Examiner

Southern Mutual Church Insurance

Columbia, SC • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted yesterday

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Job description

Southern Mutual Church Insurance Company located in Columbia, SC is a leading provider of property and casualty insurance serving the church market in the southeast. We are seeking a detail-oriented and experienced Claims Examiner to join our team. The Claims Examiner is responsible for reviewing, evaluating, and resolving insurance claims in accordance with policy provisions, company guidelines, and applicable state regulations. This role requires strong analytical skills, sound judgment, and the ability to communicate effectively with policyholders, agents, adjusters, attorneys, and other stakeholders. 3-5 years property and casualty claims experience preferred.

About Southern Mutual Church Insurance

We are a respected property and casualty insurance organization dedicated to providing exceptional service, responsive claims handling, and trusted insurance solutions. Our success is built on strong relationships, integrity, and a commitment to doing the right thing for our policyholders, agents, and employees.

We believe that our employees are our greatest asset and people matter. When you join our team, you're more than just an employee. You'll be part of a company that values its people and demonstrates that commitment through a strong total rewards package, and a supportive workplace culture where employees feel respected and supported.


Job Title: Claims Examiner 

Reports to: Claims Manager

Status: Full Time                                                                    

Job Summary:

The Claims Examiner reviews insurance claims to verify that due process was followed and ensure legal compliance, approve or deny insurance claims and provide customer service to policyholders and claims adjusters as necessary.

Supervisory Responsibilities:

No

Duties/Responsibilities:

1.      Reviews reports to ensure that no errors have been made in the appraisal process.

2.      Settles, authorizes or denies payments for routine property/casualty claims based on coverage, appraisal and verifiable damage.

3.      Works with attorneys, reinsurers, adjusters, agents and policyholders in processing claims.

4.      Keeps claims files organized and maintained ensuring accuracy and privacy.

5.      Provides information to accounting to payout claims weekly.

6.      Reviews each file for subrogation opportunities and develops facts to support the likeliness of successful recovery.

7.      Prepare appropriate claim updates for management and excess carriers.

8.      Maintains timely and professional communications with insured.

9.      Reviews insurance policy and state requirements for coverage determination.

10.  Establish appropriate reserves based upon competent analysis of coverage, liability and damages and adjust reserves as necessary in a timely manner upon receipt of additional relevant information.

11.  Effectively communicates claim decisions verbally and in writing to policyholders, claimants, attorneys and agents.

12.  Notifies Underwriting department of potential underwriting issues.

13.  Maintains current diary, workplan and activities via Image Right to bring claims to timely resolution.

14.  Complete necessary claim reporting to management including high exposure alert notifications.

15.  Maintains current diary, workplan and activities via ImageRight.

16.  Assists with training and acts as a mentor for new and existing Claims Technicians.

Required Skills/Abilities:

·         3+ years’ experience in Property and Casualty field.

·         Adjusters license required in the states in which the position handles, including completing the requisite continuing education.

·         Proficient in Microsoft Office Suite.

·         Demonstrated knowledge of property insurance contract and the ability to analyze coverage questions.

·         Insurance certificates, courses, or professional designations a plus.

·         Demonstrated ability to handle complex and/ or litigated claims. Familiarity with state regulations,   investigative practices, and coverage analysis.


Education and Experience:

Bachelor’s degree in business administration, Risk Management & Insurance or related field or an equivalent combination of education and property & casualty claims experience. Professional designations desirable, including but not limited to: Associate in Claims (AIC), Chartered Property Casualty Underwriter (CPCU), Associate in Insurance Services (AIS).  3-5 years of P&C claims adjusting or claims examination experience desirable.

 

Physical Requirements:

Prolonged periods of sitting at a desk and working on a computer.

Must be able to lift to 15 pounds at times.

Other duties

Duties, responsibilities and activities may change at any time with or without notice.

EEO statement:

We are committed to providing equal employment opportunities without regard to any statuses protected by federal, state or local law.

Company Description

We take pride not only in delivering reliable protection for our policyholders, but also in cultivating a workplace where our employees feel valued, supported, and empowered to succeed.