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Claims Research Associate Jobs in Colorado (NOW HIRING)

TriOptus LLC

Claims Processors

Denver, CO · On-site

$17.50 - $22.25/hr

Monitor and clear pended claims as necessary via research and system updates/corrections ... Associates degree or Certificate in healthcare sciences, health information technology or a related ...

InnovAge

Claims Processor II

Denver, CO · Remote

$22.84 - $31.97/hr

Monitor and clear pended claims as necessary via research and system updates/corrections ... Associates degree or Certificate in healthcare sciences, health information technology or a related ...

InnovAge

Claims Processor II

Denver, CO · On-site +1

$22.84 - $27.40/hr

Monitor and clear pended claims as necessary via research and system updates/corrections ... Associates degree or Certificate in healthcare sciences, health information technology or a related ...

Capital Rx

Pharmacy Pricing Appeals Analyst

Denver, CO · On-site

$27.31 - $34.13/hr

Associates Degree preferred; equivalent combination of education and pharmacy/PBM experience may be considered * Direct experience researching, validating, or resolving pharmacy claims * Experience ...

New

W3Global Inc.

Associate Attorney

Denver, CO

$125K - $190K/yr

Investigating/defending first- and third-party claims * Conducting and defending depositions ... Legal Research, writing, and independent thinking skills * Handle the day-to-day responsibility for ...

MWH

Associate General Counsel

Broomfield, CO · On-site

Manage construction claims, disputes, and litigation arising from MWH's water, wastewater, and ... Strong legal research, writing, negotiation, analytical, and oral communication skills. * Ability ...

MWH

Associate General Counsel

Broomfield, CO · On-site

Manage construction claims, disputes, and litigation arising from MWH's water, wastewater, and ... Strong legal research, writing, negotiation, analytical, and oral communication skills. * Ability ...

MWH

Associate General Counsel

Broomfield, CO · On-site

Manage construction claims, disputes, and litigation arising from MWH's water, wastewater, and ... Strong legal research, writing, negotiation, analytical, and oral communication skills. * Ability ...

MWH

Associate General Counsel

Broomfield, CO · On-site

Manage construction claims, disputes, and litigation arising from MWHs water, wastewater, and heavy ... Strong legal research, writing, negotiation, analytical, and oral communication skills. * Ability ...

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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 12, 2026, the average hourly pay for claims research associate in Colorado is $22.07, according to ZipRecruiter salary data. Most workers in this role earn between $17.93 and $24.28 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 in Colorado are hiring for Claims Research Associate jobs?

Cities in Colorado with the most Claims Research Associate job openings:

Claims Research Associate jobs near you

Claims Processors

Denver, CO • On-site

TriOptus LLC
IT Services • 51 - 200 employees
Learn more about TriOptus LLCexternal

$17.50 - $22.25/hr

Other

Re-posted 14 days ago

Job description

Job Title: Claims Processors
Location: Denver, CO 80210
Duration: 6-month contract (potential- contract to hire)
Compensation- $50,000 + Benefits
Logistics
  • First 2-3 weeks will be in the office for training
  • 2 days in-office thereafter- but can be Remote if you perform well independently after training
  • Shift- Flexibility on the hours- can start early or around 9 if they want to
Description
The Claims Processor II is responsible for ensuring the accurate and timely processing of all UB, HCFA and Dental claims submitted by external providers for participant care per company and CMS guidelines. This position monitors and processes claim audits to maximize accuracy and minimize expense, using various software and customized applications. The position interacts with all external providers, vendors, and external agencies on issues related to claims submission, process and payment.
  • Train providers and address provider appeals per CMS and NCCI guidelines adjusting claims as appropriate.
  • Monitor and clear pended claims as necessary via research and system updates/corrections.
  • Downgrades DRG claims and reprocesses per the direction of InnovAge's external audit vendor.
  • Processes provider refunds, creating, coordinating and reconciling activity with AP.
  • Receives inbound customer service calls and e-mails, answering claims questions in regards to claim status, verification of eligibility/benefits, billing and payment per CMS, NCCI and InnovAge guidelines.
  • Monitor Smart Data claims activity and work rejected claims by making necessary adjustments to the claim so transmission to the Claims system is possible
  • Clear pended claims. Pull reports daily to research and resolve the issues stopping the claim from processing, up to and including loading provider data to the PCM claims system.
  • Conduct weekly batch reviews, monitoring a reviewing a host of internal reports to maximize accuracy of claim payments
  • Under the supervision of the team lead load new providers to InnovAge's PCM Network to allow claims to process and pay per expectations
  • Work with Center Leadership to approve claims from non-contracted providers, communicating the need for contracts as necessary
  • Research and resolve Provider reconciliations to address billing/payment issues - research claims and communicate resolution to provider.
  • Performs provider fee schedule maintenance for Housing providers
  • Train external providers on how to execute and CMS UB04, HCFA or Dental claim as necessary
  • Process Refunded payments back to the claims system, ensuring shared spreadsheets are up to date and accurately maintained for reconciliation purposes with accounting
  • Work claims audits generated by Virtual Examiner -500-1500 weekly
  • Work IP audits generate by Varis, adjusting claims and submitting invoices to AP
  • Reviews and responds to Provider appeals, including research, claims adjustment and drafting responses to providers
  • Resolves claims issues through contact with participants, physicians, facilities and others and makes changes to claims based on results of those conversations.
  • Hand key paper claims activity that is loaded in KL i.e. Smart Data rejects
Required
  • 3+ as a Claims Processor or similar position in either a doctor's office, healthcare clinic or other healthcare setting; or equivalent combination of education and experience.
  • Ability to type 10,000+ KSPH (alpha/numeric), in addition to being able to produce business correspondence to both participants and regulatory agencies
  • Must have intermediate customer service skills and be able to research and communicate information to callers in a timely manner.
  • Experience with basic office machines such as copiers, scanners and multi-line phone systems are essential.
  • Current experience in communicating claims issues with physicians and their staff, participants, and other regulatory agencies
  • Associates degree or Certificate in healthcare sciences, health information technology or a related field from an accredited college
Preferred
  • Experience with medical billing and/or coding as well as document imaging systems and Medical Terminology.
  • Prior experience working with Plexis, Virtual Examiner, ABCT, Encoder Plus
  • Prior Audit experience
  • Bi-lingual in Spanish

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