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How much do claims resolution specialist jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for claims resolution specialist in the United States is $23.50, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $25.72 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a claims resolution specialist, and why are they important?

To excel as a Claims Resolution Specialist, you need strong analytical abilities, attention to detail, and a background in insurance or finance, often supported by a relevant degree or industry certification. Familiarity with claims management software, customer relationship management (CRM) systems, and regulatory compliance tools is standard in this role. Outstanding communication, negotiation, and problem-solving skills help you resolve disputes efficiently and maintain positive client relationships. These competencies are crucial for ensuring timely, accurate claims processing and upholding customer satisfaction and regulatory standards.

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

AspectClaims Resolution SpecialistClaims Adjuster
CredentialsTypically requires insurance-related certifications or licensesRequires similar licenses and certifications, often the same as Claims Resolution Specialist
Work EnvironmentOffice settings, customer service interactions, claims processingFieldwork and office work, investigating claims on-site or remotely
Employer & IndustryInsurance companies, third-party administratorsInsurance companies, third-party administrators
Primary FocusResolving claims, customer communication, ensuring policy complianceInvestigating, evaluating, and settling claims

Both roles involve working within the insurance industry and require similar certifications. While Claims Resolution Specialists focus on customer communication and resolving claims efficiently, Claims Adjusters often handle the investigation and evaluation process, sometimes in the field. Understanding these differences can help job seekers identify the right position based on their skills and career goals.

What are some common challenges faced by claims resolution specialists and how are they typically addressed?

Claims Resolution Specialists often encounter challenges such as managing a high volume of complex cases, communicating with dissatisfied clients, and navigating intricate insurance policies. To address these, specialists rely on strong organizational skills, effective communication, and a thorough understanding of industry regulations. Many employers also provide ongoing training and access to digital tools to help streamline the claims process and support collaboration with adjusters and other departments.

What does a claims resolution specialist do?

A Claims Resolution Specialist is responsible for reviewing, investigating, and resolving insurance claims to ensure they are processed accurately and efficiently. They communicate with policyholders, providers, and other stakeholders to gather necessary information, analyze documentation, and determine the validity of claims. Their main goal is to resolve disputes or discrepancies in claims, making sure that payments are made correctly and in accordance with company policies and regulations.
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Claims Resolution Specialist jobs near you
Infographic showing various Claims Resolution Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $48,885 per year, or $23.5 per hour.

Claims Resolution Specialist II, No Fault

Liberty Mutual

Plano, TX • On-site

$101K/yr

Full-time

This job post has expired today. Applications are no longer accepted.

Liberty Mutual rating

8.9

Company rating: 8.9 out of 10

Based on 148 frontline employees who took The Breakroom Quiz

48th of 304 rated insurance

Job description

Description
Manages, investigates and resolves medical claims assigned by the Claims Team Manager and assists in providing service to policyholders and agents under general supervision. May perform field investigation on assigned cases and make recommendations on additional work as indicated. Recognizes and solves problems of moderate scope and complexity.
Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory
NJ No Fault experience is required.
Responsibilities:
  • Manages, evaluates and resolves claims assigned by Claims Team Manager. Evaluates liability, medical necessity, causality and settles claims within prescribed authority.
  • Communicates with policyholders, agents, witnesses, and claimants in order to gather information regarding claims and refers tasks to auxiliary resources as necessary. Responds to various written and telephone inquiries including status reports.
  • Reviews medical records and bills to verify claimed treatment is causally related to the accident and is reasonable and necessary given facts of the claim.
  • Ensures adequacy of reserves and settlement authority.
  • Confirms or denies coverage and liability and advises policyholders, agents and claimants as to proper course of action.
  • Makes effective use of loss management techniques (IMEs, Nurse Review, and Bill Review). Negotiates settlements with attorneys, claimants, and medical providers. Arranges for expert inspections involving third party or potential fraud actions as needed.
  • Updates files and provides comprehensive reports as required.
  • Identifies and recommends referral of potentially fraudulent claims to the Special Investigation Unit.
  • Recognizes continuous improvement opportunities and develops.
Qualifications
  • Strong written and oral communications skills required. Good interpersonal, analytical, decision making, and negotiation skills required.
  • Customer service experience preferred.
  • Knowledge of legal liability, general insurance policy coverage and the ability to review and understand medical records to determine causality and medical necessity.
  • The capabilities, skills and knowledge required is normally acquired through a Bachelor's degree or equivalent experience and 6-12 months of directly related experience.
  • Ability to obtain proper licensing as required.
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: https://www.libertymutualgroup.com/about-lm/careers/benefits
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
  • California
  • Los Angeles Incorporated
  • Los Angeles Unincorporated
  • Philadelphia
  • San Francisco

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About Liberty Mutual

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Since 1912, we've grown into the fifth largest global property and casualty insurer based on 2022 gross written premium. We also rank 86 on the Fortune 100 list of largest corporations in the US based on 2022 revenue. ​At Liberty Mutual Insurance we work hard every day to support our customers and our people, so they can protect their families, build their businesses and invest in their futures. We are headquartered in Boston, but our people, our customers and our reach span the globe. So to better serve our global customers and employees, we are organized into three business units.

Industry

Insurance services

Company size

10,000+ Employees

Headquarters location

Boston, MA, US

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