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Claims Resolution Coordinator Jobs (NOW HIRING)

Vytwo

Claims Examiner - Workers Compensation

Prosper, TX · On-site

$35/hr

Manages the litigation process; ensures timely and cost effective claims resolution. * Coordinates vendor referrals for additional investigation and/or litigation management. * Uses appropriate cost ...

Perdue Farms

Claims Coordinator

Salisbury, MD

$20 - $30/hr

... Coordinator. In this role, you will partner closely with customers, brokers, sales teams, and ... supporting efficient claims resolution. This opportunity is ideal for a detail-oriented ...

New

Perdue Farms

Claims Coordinator

Salisbury, MD

$20 - $30/hr

... Coordinator. In this role, you will partner closely with customers, brokers, sales teams, and ... supporting efficient claims resolution. This opportunity is ideal for a detail-oriented ...

New

Sedgwick

Claims Examiner

Las Vegas, NV

Manages the litigation process; ensures timely and cost effective claims resolution. * Coordinates vendor referrals for additional investigation and/or litigation management. * Uses appropriate cost ...

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How much do claims resolution coordinator jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for claims resolution coordinator in the United States is $21.04, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $24.04 per hour, depending on experience, location, and employer.

What does a claims resolution coordinator do?

A Claims Resolution Coordinator is responsible for reviewing, investigating, and resolving insurance or billing claims that have been denied, delayed, or are otherwise outstanding. They work closely with insurance companies, healthcare providers, and patients to gather necessary information and documentation, ensuring claims are processed correctly and efficiently. Their goal is to minimize claim denials and maximize reimbursement by identifying and addressing issues in the claims process. Effective communication, attention to detail, and a thorough understanding of insurance policies and billing procedures are essential in this role.

What are some common challenges faced by claims resolution coordinators when working with insurance providers and clients?

Claims Resolution Coordinators often encounter challenges such as navigating complex policy details, managing tight deadlines, and communicating effectively with both insurance providers and clients who may be frustrated or anxious about their claims. Coordinators must be adept at problem-solving and remain patient and empathetic while gathering documentation, clarifying coverage, and negotiating settlements. Collaboration with other departments, such as billing or legal, is common to help resolve discrepancies and ensure a smooth claims process.

What are the key skills and qualifications needed to thrive as a claims resolution coordinator?

To thrive as a Claims Resolution Coordinator, you need strong analytical abilities, attention to detail, and knowledge of insurance or healthcare claims processes, often supported by a relevant associate’s or bachelor’s degree. Familiarity with claims management software, billing systems, and regulatory compliance tools is typically required. Excellent communication, problem-solving skills, and the ability to manage conflict set top performers apart in this role. These skills are crucial for ensuring timely and accurate claim resolution, reducing errors, and maintaining positive relationships with clients and stakeholders.

What is the difference between Claims Resolution Coordinator vs Claims Adjuster?

AspectClaims Resolution CoordinatorClaims Adjuster
CredentialsHigh school diploma or equivalent; some roles may require insurance certificationsHigh school diploma; insurance licensing often required
Work EnvironmentOffice setting, team collaboration, customer service focusOffice or field work, investigating claims, interacting with claimants and providers
Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Primary ResponsibilitiesCoordinate claim resolution processes, communicate with claimants, ensure timely processingEvaluate damages, determine claim validity, authorize payments

The Claims Resolution Coordinator primarily focuses on coordinating and facilitating the claims process, ensuring smooth communication and resolution. In contrast, Claims Adjusters evaluate claims directly, investigate damages, and make payment decisions. Both roles are essential in the insurance industry but differ in their core functions and responsibilities.

More about Claims Resolution Coordinator jobs
What cities are hiring for Claims Resolution Coordinator jobs? Cities with the most Claims Resolution Coordinator job openings:
What are the most commonly searched types of Claims Resolution jobs? The most popular types of Claims Resolution jobs are:
What states have the most Claims Resolution Coordinator jobs? States with the most job openings for Claims Resolution Coordinator jobs include:
What job categories do people searching Claims Resolution Coordinator jobs look for? The top searched job categories for Claims Resolution Coordinator jobs are:
Claims Resolution Coordinator jobs near you
Infographic showing various Claims Resolution Coordinator job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 8% Part Time, 1% Temporary, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $43,758 per year, or $21 per hour.

Claims Examiner - Workers Compensation

Apidel Technologies

Roseville, CA • Remote

$34.25 - $46.75/hr

Full-time

Re-posted 7 days ago

Job description

Duties:
Minimum 3years of relevant CA WC claims experience is mandatory
California WC Claims handling experience
Must have OSIP certificate
Remote but within California
To analyze complex or technically difficult workers\' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

Primary Purpose:
To analyze complex or technically difficult workers\' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
Essential Functions And Responsibilities
Analyzes and processes complex or technically difficult workers\' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
Negotiates settlement of claims within designated authority.
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
Prepares necessary state fillings within statutory limits.
Manages the litigation process; ensures timely and cost effective claims resolution.
Coordinates vendor referrals for additional investigation and/or litigation management.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
Ensures claim files are properly documented and claims coding is correct.
Refers cases as appropriate to supervisor and management.
Additional Functions And Responsibilities
Performs other duties as assigned.
Supports the organization\'s quality program(s).
Travels as required.
Qualification
Education & Licensing
Bachelor\'s degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
Experience
Five (5) years of claims management experience or equivalent combination of education and experience required.


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About Apidel Technologies

Sourced by ZipRecruiter

We understand that attracting, qualifying, placing, and retaining the best candidates for our clients requires exceptional talent. That’s why our highly skilled and dedicated recruitment team works tirelessly to develop lifelong associations with all candidates and clients. We prioritize helping our employees achieve their career goals while providing effective staffing solutions to our clients and candidates. At Apidel, we believe in simple yet established core values that are ingrained within each member of our team. These values are time and again illustrated in our approach to employees, candidates, and clients. Our unwavering belief that our core values of integrity, client satisfaction, innovation, and intellect distinguish us from our competitors is what drives us forward. We remain focused on improving and sustaining a measurable client satisfaction program that has created an organizational culture where our associates provide world-class service every day.

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Plainfield, IL, US

Year founded

2012

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