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Claims Examiner 1 Jobs (NOW HIRING)

Imagenet

Claims Examiner - Remote

Tampa, FL · On-site +1

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 ...

Medix

Claims Examiner

Tulsa, OK · On-site

$20 - $20.50/hr

Responsibilities The Temporary Claims Examiner/Tester is responsible for auditing, processing, and ... Medix has also been ranked as one of the fastest growing companies by Inc. Magazine. Our commitment ...

Auxiant

Claims Examiner

Cedar Rapids, IA · On-site

... a Claims Examiner. Auxiant is a third party administrator of self-funded employee benefit plans ... Medical Terminology * High school diploma and 1-2 years related experience; or equivalent ...

Insperity

Medical Claims Examiner

CA · Remote

$24 - $30/hr

Description & Requirements Medical Claims Examiner- Chatsworth Local Remote or In-Office Join a ... Apply now and help us transform lives-one claim at a time! We are an equal opportunity employer ...

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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.
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What job categories do people searching Claims Examiner 1 jobs look for?

The top searched job categories for Claims Examiner 1 jobs are:

Claims Examiner 1 jobs near you
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 - Remote

Imagenet

Tampa, FL • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted yesterday

Job description

Claims Examiner - Remote
Job Type: Full-time
Work Setup: This is a fully remote position
Work Hours: Pacific Time Zone
We are looking for Experienced Claims Examiner to join our rapidly growing team.
Experience is required for this position.
Job Overview:
As a Claims Examiner, you will be responsible for accurately reviewing, investigating, and processing medical claims and provider dispute requests in accordance with payer guidelines, contractual agreements, regulatory requirements, and internal policies.
Responsibilities:
  • Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.
  • Review and investigate provider dispute requests, appeals, and reconsiderations related to processed medical claims.
  • Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.
  • Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues.
  • Participate in ongoing training and professional development activities.
  • Maintain accurate and detailed records of claims processing activities.
  • Review claim forms and supporting documents
  • Determine eligibility, verify data accuracy
  • Request additional information when needed
  • Process claims end-to-end
  • Identify and escalate complex or unusual claims for further review or investigation.
  • Participate in ongoing training and professional development activities.
  • Handle more complex claims with multiple services, providers

Experience:
  • At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment.
  • Experience processing Provider Dispute Resolution (PDR), appeals, reconsiderations, or claim adjustments is highly preferred.
  • Understanding of health claims processing/adjudication
  • Ability to perform basic to intermediate mathematical computation routines
  • Medical terminology strongly preferred
  • Understanding of ICD-9 & ICD-10
  • Basic MS office computer skills
  • Ability to work independently or within a team
  • Time management skills
  • Written and verbal communication skills
  • Attention to detail
  • Must be able to demonstrate sound decision-making skills

What We Offer
  • Remote work offered
  • Equipment provided
  • Paid training to set you up for success
  • Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
  • Paid Time Off (PTO)
  • 7 paid holidays
  • A supportive team and a company that values internal growth

Ready to Grow Your Career?
We'd love to meet you! Click "Apply Now" and tell us why you'd be a great addition to the Imagenet team.
About Imagenet
Imagenet is a technology-forward healthcare operations partner with more than 25 years of experience helping healthcare payers manage critical administrative and operational processes. Founded in 2000 and headquartered in Tampa, Florida, Imagenet supports 150+ health plans through its payer clients.
Our teams help improve efficiency, accuracy, visibility, and service across complex healthcare operations, including digital mailroom, claims adjudication, contact center, member communications, and related administrative functions. By combining experienced operational teams, proven processes, and purpose-built workflow technology, Imagenet helps payers keep essential processes moving for the members, providers, and communities they serve.
Imagenet operates 10 secure facilities across the U.S. and one secure facility in Manila, Philippines.
Joining Imagenet means contributing to work that supports the healthcare operations members and providers rely on every day.

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