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Claims Research Associate Jobs (NOW HIRING)

Humana

Claims Research and Resolution Prof

Comprised of a group of calls/claims/provider associates researching the resolution to a pending call. Understand department, segment, and organizational strategy and operating goals, including their ...

Humana

Claims Research and Resolution Prof

Comprised of a group of calls/claims/provider associates researching the resolution to a pending call. Understand department, segment, and organizational strategy and operating goals, including their ...

Humana

Sr Claims Research and Resolution

Comprised of a group of calls/claims/provider associates researching the resolution to a pending call. Begin to influence department's strategy. On moderately complex to complex issues regarding ...

Humana

Sr Claims Research and Resolution

Comprised of a group of calls/claims/provider associates researching the resolution to a pending call. Begin to influence department's strategy. On moderately complex to complex issues regarding ...

Humana

Claims Research and Resolution Prof

Comprised of a group of calls/claims/provider associates researching the resolution to a pending call. Understand department, segment, and organizational strategy and operating goals, including their ...

Humana

Sr Claims Research and Resolution

Comprised of a group of calls/claims/provider associates researching the resolution to a pending call. Begin to influence department's strategy. On moderately complex to complex issues regarding ...

TRILLIUM HEALTH RESOURCES

Claims Specialist III

NC · Remote

$56K - $69K/yr

... claims research; OR * Associate's degree and four (4) years of experience managing deadlines ... preparing and reviewing written correspondence, and maintaining records or research in a healthcare ...

NRECA

Specialty Claims Associate

Lincoln, NE · On-site

$48K - $60K/yr

The Specialty Claims Associate processes and adjudicates FSA and HRA claims, research claim information, and delivers exceptional member service while meeting productivity and quality standards. The ...

Stratevi

Senior Research Associate

Boston, MA · On-site

$95K/yr

... claims, EHR, hospital billing, and/or national survey data sets. In doing so, Senior Research ... In doing so, Senior Research Associates may draft model plans, program models, confirm model ...

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Claims Research Associate information

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How much do claims research associate jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for claims research associate in the United States is $20.99, according to ZipRecruiter salary data. Most workers in this role earn between $17.07 and $23.08 per hour, depending on experience, location, and employer.

What is a claims research associate?

Claims Research Associates are professionals who investigate and analyze insurance claims to determine their validity and ensure they comply with policy terms. They gather and review documentation, interview relevant parties, and communicate findings to claims adjusters or insurance companies. Their work helps prevent fraud and ensures that clients receive fair compensation. Claims Research Associates often work in insurance companies, healthcare organizations, or third-party administrators.

What are the key skills and qualifications needed to thrive as a claims research associate?

To thrive as a Claims Research Associate, you need strong analytical abilities, attention to detail, and a background in insurance, finance, or a related field—often supported by a relevant degree or experience. Familiarity with claims management software, databases, and Microsoft Office Suite is typically required, and some positions may value industry certifications like AIC (Associate in Claims). Excellent communication, problem-solving skills, and the ability to manage time effectively help set top performers apart. These skills ensure accurate investigation and resolution of claims, which is essential for minimizing risk and providing excellent customer service.

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

Claims Research Associates often encounter challenges such as analyzing incomplete or ambiguous claim information, managing a high volume of cases, and coordinating with multiple departments to resolve discrepancies. Successfully managing these challenges requires strong attention to detail, effective organizational skills, and clear communication with both internal teams and external parties. Utilizing available claims management systems and regularly collaborating with colleagues can help streamline processes and ensure accurate claim resolution.

What is the difference between Claims Research Associate vs Claims Adjuster?

AspectClaims Research AssociateClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may prefer associate degreesHigh school diploma or equivalent; licensing may be required depending on state
Work EnvironmentOffice setting, research-focused tasksField and office settings, investigating claims
Industry UsageInsurance companies, third-party administratorsInsurance companies, public agencies
Common Search/ComparisonClaims Research Associate vs Claims Adjuster

The main difference between a Claims Research Associate and a Claims Adjuster lies in their roles. Claims Research Associates primarily focus on gathering and analyzing information related to insurance claims, often working in an office environment. Claims Adjusters, on the other hand, investigate claims directly, sometimes in the field, and make decisions on claim validity and settlement. Both roles require knowledge of insurance policies, but Claims Adjusters typically need licensing, whereas Claims Research Associates focus more on research skills.

How can I become a claims research associate?

To become a claims research associate, candidates typically need a high school diploma or equivalent, with some roles preferring a bachelor's degree in fields like insurance, business, or related areas. Relevant skills include attention to detail, analytical thinking, and proficiency with data management tools. Gaining experience through internships or entry-level positions in insurance or claims processing can also improve job prospects.

Is claims research a stressful job?

Claims research as a Claims Research Associate involves analyzing insurance claims, which can be demanding due to tight deadlines and the need for accuracy. The job may involve repetitive tasks and detailed data review, but stress levels vary depending on workload, company environment, and individual coping skills.

What cities are hiring for Claims Research Associate jobs?

Cities with the most Claims Research Associate job openings:

What states have the most Claims Research Associate jobs?

States with the most job openings for Claims Research Associate jobs include:

What are popular job titles related to Claims Research Associate jobs?

For Claims Research Associate jobs, the most frequently searched job titles are:

Claims Research Associate jobs near you

Claims Research and Resolution Prof

Remote

Humana
Health Care and Social Assistance • 10K+ employees
Learn more about Humanaexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago

Humana rating

8.0

Company rating: 8.0 out of 10

Based on 267 frontline employees who took The Breakroom Quiz

Job description

Become a part of our caring community
The Claims Research & Resolution Professional 2 manages claims operations that involve customer contact, investigation, and settlement of claims for and against us. Approve all claim settlements both for and against us. The Claims Research & Resolution Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Claims Research & Resolution Professional 2 works with insurance companies, providers, members, and collection services in the settlement of claims. Comprised of a group of calls/claims/provider associates researching the resolution to a pending call. Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas. Regarding own work methods, occasionally in, and and receive guidance where needed. Follow established guidelines/procedures.


Use your skills to make an impact

Required Qualifications

  • Bachelor's degree
  • Less than 5 years of technical experience
  • Must be passionate about contributing to an organization focused on improving consumer experiences
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$59,300 - $80,900 per year


This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

What Humana employees say

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Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Humana logo

About Humana

Sourced by ZipRecruiter

Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Louisville, KY, US

Year founded

1961

Social media

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