Required Experience: 0-2 years of claims processing with advancement to auditing / claims analysis / claims research. * Some project management skills. Good oral and written communication skills.
Required Experience: 0-2 years of claims processing with advancement to auditing / claims analysis / claims research. * Some project management skills. Good oral and written communication skills.
The Medical Claims Billing Specialist is responsible for reviewing, researching, and resolving healthcare insurance claims to ensure accurate and timely reimbursement. This role focuses on correcting ...
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The Medical Claims Billing Specialist is responsible for reviewing, researching, and resolving healthcare insurance claims to ensure accurate and timely reimbursement. This role focuses on correcting ...
Claims Analyst
Baltimore, MD · On-site
Research, review, and validate claims data to ensure accuracy and timely processing. * Investigate claim discrepancies, perform root cause analysis, and recommend resolutions. * Support operational ...
Claims Analyst
Baltimore, MD · On-site
Research, review, and validate claims data to ensure accuracy and timely processing. * Investigate claim discrepancies, perform root cause analysis, and recommend resolutions. * Support operational ...
Medical Claims Supervisor
Gastonia, NC · On-site
... researching claim issues, and ensuring timely and accurate adjudication of claims in accordance with health plan benefits, provider contracts, regulatory requirements, and internal performance ...
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Medical Claims Supervisor
Gastonia, NC · On-site
... researching claim issues, and ensuring timely and accurate adjudication of claims in accordance with health plan benefits, provider contracts, regulatory requirements, and internal performance ...
Medical Claims Analyst
Juneau, AK · On-site
$31.83 - $44.56/hr
This role performs claims review and processing, eligibility verification, referral validation, payment research, system administration, workflow support, and data integrity monitoring to ensure ...
Medical Claims Analyst
Juneau, AK · On-site
$31.83 - $44.56/hr
This role performs claims review and processing, eligibility verification, referral validation, payment research, system administration, workflow support, and data integrity monitoring to ensure ...
Provide expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims * Leads operational strategy to reduce costs while ...
Provide expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims * Leads operational strategy to reduce costs while ...
Claims Operations Manager
Indianapolis, IN · On-site
Provide expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims * Leads operational strategy to reduce costs while ...
Claims Operations Manager
Indianapolis, IN · On-site
Provide expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims * Leads operational strategy to reduce costs while ...
Research contract terms/interpretation and compile necessary supporting documentation for appeals ... claims research * Payer Knowledge - MUST be strong in payer knowledge & being able to identify ...
Research contract terms/interpretation and compile necessary supporting documentation for appeals ... claims research * Payer Knowledge - MUST be strong in payer knowledge & being able to identify ...
Accounting Clerk - Claims Processing
Columbus, OH · On-site
$15 - $18/hr
Research and collect supporting documentation to validate claim eligibility * Ensure compliance ... Investigate complex claims through detailed research and documentation * Serve as a primary point ...
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Accounting Clerk - Claims Processing
Columbus, OH · On-site
$15 - $18/hr
Research and collect supporting documentation to validate claim eligibility * Ensure compliance ... Investigate complex claims through detailed research and documentation * Serve as a primary point ...
Research and verify policy coverage and claim eligibility. * Identify, investigate, and escalate suspicious or potentially fraudulent claims. * Review claim reports and decision letters for accuracy ...
New
Research and verify policy coverage and claim eligibility. * Identify, investigate, and escalate suspicious or potentially fraudulent claims. * Review claim reports and decision letters for accuracy ...
New
Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Title : Claims Analyst I Location : Syracuse, NY Duration : 3+ Months (Possible extension) Responsibilities : Mon ...
Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Title : Claims Analyst I Location : Syracuse, NY Duration : 3+ Months (Possible extension) Responsibilities : Mon ...
Research Lead
Melbourne, FL · On-site
$60K - $120K/yr
Conduct user research, beta testing, and claims research * Socialize research findings and ensure team members can self-support by creating tools to access your research * Write, field, and analyze ...
Research Lead
Melbourne, FL · On-site
$60K - $120K/yr
Conduct user research, beta testing, and claims research * Socialize research findings and ensure team members can self-support by creating tools to access your research * Write, field, and analyze ...
Research Lead
$60K - $120K/yr
Conduct user research, beta testing, and claims research * Socialize research findings and ensure team members can self-support by creating tools to access your research * Write, field, and analyze ...
Quick apply
Research Lead
$60K - $120K/yr
Conduct user research, beta testing, and claims research * Socialize research findings and ensure team members can self-support by creating tools to access your research * Write, field, and analyze ...
Detailed in your work, and claims research * Ability to be flexible to fast-paced changing business needs Experience and Education: * Bachelors degree with an emphasis on risk management, business ...
Detailed in your work, and claims research * Ability to be flexible to fast-paced changing business needs Experience and Education: * Bachelors degree with an emphasis on risk management, business ...
Claims Analyst
Minneapolis, MN · On-site
$52K - $62K/yr
This will include claims research where applicable and a range of claim complexity. Salary Range : $52,000 - $62,000 A SAMPLE OF WHAT YOU'LL GET TO DO IN THIS JOB * Review, analyze, and adjudicate ...
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Claims Analyst
Minneapolis, MN · On-site
$52K - $62K/yr
This will include claims research where applicable and a range of claim complexity. Salary Range : $52,000 - $62,000 A SAMPLE OF WHAT YOU'LL GET TO DO IN THIS JOB * Review, analyze, and adjudicate ...
New
Detailed in your work, and claims research * Ability to be flexible to fast-paced changing business needs Experience and Education: * Bachelors degree with an emphasis on risk management, business ...
Detailed in your work, and claims research * Ability to be flexible to fast-paced changing business needs Experience and Education: * Bachelors degree with an emphasis on risk management, business ...
Detailed in your work, and claims research * Ability to be flexible to fast-paced changing business needs Experience and Education: * Bachelors degree with an emphasis on risk management, business ...
Detailed in your work, and claims research * Ability to be flexible to fast-paced changing business needs Experience and Education: * Bachelors degree with an emphasis on risk management, business ...
Research and respond to inquiries from insureds, claimants, agency partners, and carriers. * Meet with clients to discuss complex claims and coverage issues. * Maintain open communication with ...
New
Research and respond to inquiries from insureds, claimants, agency partners, and carriers. * Meet with clients to discuss complex claims and coverage issues. * Maintain open communication with ...
New
Pharmacy Benefits Specialist
Pittsburgh, PA · On-site
In this role, you will process pharmacy claims, research insurance coverage, and collaborate with internal teams to ensure patients receive timely and accurate support. Pay Rate : 18-20+ per hour ...
Pharmacy Benefits Specialist
Pittsburgh, PA · On-site
In this role, you will process pharmacy claims, research insurance coverage, and collaborate with internal teams to ensure patients receive timely and accurate support. Pay Rate : 18-20+ per hour ...
Claims Examiner
Louisville, KY · On-site
$17 - $20/hr
Claims & Appeals & Grievances (A&G) Specialist Department: Healthcare Operations Location: United ... Perform claim research to identify discrepancies, missing information, eligibility concerns ...
Claims Examiner
Louisville, KY · On-site
$17 - $20/hr
Claims & Appeals & Grievances (A&G) Specialist Department: Healthcare Operations Location: United ... Perform claim research to identify discrepancies, missing information, eligibility concerns ...
Claims Research information
See salary details
$11.54 - $14.31
4% of jobs
$14.31 - $17.09
14% of jobs
$18.17 is the 25th percentile. Wages below this are outliers.
$17.09 - $19.86
19% of jobs
The median wage is $21.67 / hr.
$19.86 - $22.64
21% of jobs
$22.64 - $25.42
14% of jobs
$26.53 is the 75th percentile. Wages above this are outliers.
$25.42 - $28.19
10% of jobs
$28.19 - $30.97
4% of jobs
$30.97 - $33.74
5% of jobs
$33.74 - $36.52
3% of jobs
$36.52 - $39.29
3% of jobs
$39.29 - $42.07
3% of jobs
$11
$24
$42
How much do claims research jobs pay per hour?
As of Aug 18, 2026, the average hourly pay for claims research in the United States is $24.12, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $27.40 per hour, depending on experience, location, and employer.
What is a claims research professional?
Claims research professionals are specialists who investigate and analyze insurance claims to determine their validity and ensure compliance with policy terms. They gather information, review documentation, and may interview claimants or witnesses to verify details. Their work helps insurance companies prevent fraud, process legitimate claims efficiently, and resolve disputes. Claims researchers play a crucial role in protecting both the insurer and the policyholder by ensuring fair and accurate claim settlements.
What are the key skills and qualifications needed to thrive as a claims research specialist, and why are they important?
To thrive as a Claims Research Specialist, you need strong analytical skills, attention to detail, and knowledge of insurance or claims processes, often supported by a relevant degree or experience in claims management. Familiarity with claims management software, databases, and sometimes certification such as AIC (Associate in Claims) is typically required. Excellent communication, problem-solving abilities, and customer service skills help you excel when interacting with clients and resolving complex cases. These skills ensure accurate claim resolution, compliance with regulations, and a positive experience for policyholders.
What are some common challenges faced in a claims research role, and how can they be managed?
A common challenge in Claims Research is navigating complex policy details and incomplete or ambiguous documentation. Researchers must often communicate with multiple stakeholders, such as policyholders, adjusters, and healthcare providers, to gather missing information and verify facts. Managing tight deadlines while ensuring accuracy is also crucial. Building strong organizational skills and maintaining clear, professional communication can help address these challenges effectively.
What is the difference between Claims Research vs Claims Adjuster?
| Aspect | Claims Research | Claims Adjuster |
|---|---|---|
| Required Credentials | High school diploma or equivalent; some roles may require insurance certifications | High school diploma or equivalent; insurance licensing often required |
| Work Environment | Office-based, research-focused, often involving data analysis | Field and office-based, investigating claims and interacting with clients |
| Industry Usage | Insurance companies, third-party administrators, claims research firms | Insurance companies, adjusting firms, third-party administrators |
| Common Search & Comparison | Yes | Yes |
Claims Research involves analyzing data and gathering information to support claims decisions, often working behind the scenes. Claims Adjusters evaluate and settle claims directly with policyholders, often working in the field. While both roles require insurance knowledge and certifications, Claims Research focuses on data analysis, whereas Claims Adjusters handle claim investigations and settlements.
Is claims research processing a stressful job?
Claims research processing can be stressful due to the need for accuracy, attention to detail, and meeting deadlines. The job often involves handling complex information and can require long periods of concentration, which may contribute to stress levels for some individuals.
More about Claims Research jobs
What are the most commonly searched types of Claims Research jobs?
The most popular types of Claims Research jobs are:
What job categories do people searching Claims Research jobs look for?
The top searched job categories for Claims Research jobs are:
Job description
Company Description
Healthcare Company
Job Description
Job Title: Claims Analyst
Duration: 1+ months contract
Location: Syracuse , New York 13212
Hours: Mon- Fri 9 am to 5:30
Job Description:
Conducts analysis around various claims payment processes to ensure accuracy of system configuration and provider payments. Investigates problem claims to determine root cause of problem and/or error to address both individual claim resolution and improvement to process to avoid issues from occurring in the future. Perform and execute various claims process testing requests to ensure desired results are met to support accurate claims payments. Testing categories include but are not limited to the following: Benefit, Contract, and Fee Schedule Configuration, System Enhancements, Report Validation, Validation of electronic file loads.
EDUCATION:
- At least one year claims knowledge.
- Looking for medical claims experience for these position.
- Top Three: Claims knowledge, efficient and work well with a group
- Required Education: High School graduate (or GED).
- Required Experience: 0-2 years of claims processing with advancement to auditing / claims analysis / claims research.
- Some project management skills. Good oral and written communication skills. Advanced Word and Excel skills.
Additional Information
All your information will be kept confidential according to EEO guidelines.
About Integrated Resources
Sourced by ZipRecruiter
Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.
Industry
Recruiting and staffing services
Company size
51 - 200 Employees
Headquarters location
Edison, NJ, US
Year founded
1996