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Claims Review Jobs (NOW HIRING)

Amwins

Claims Review Specialist

Scottsdale, AZ

Join Our Team as a Claims Review Specialist at Amwins Self-Funded, LLC! Are you ready to make a meaningful impact in the dynamic world of insurance? Join Amwins Self-Funded, LLC., as a Claims Review ...

Amwins

Claims Review Specialist

Scottsdale, AZ · On-site

Join Our Team as a Claims Review Specialist at Amwins Self-Funded, LLC! Are you ready to make a meaningful impact in the dynamic world of insurance? Join Amwins Self-Funded, LLC., as a Claims Review ...

CAPITOL BRIDGE, LLC

Claims Review Physician (57795)

$250/wk

Claims Review Physician Fully Remote Overview Position Type: Contractor Job Shift: Any Description Capitol Bridge is currently seeking Board Certified Physicians, licensed in any state, for remote ...

EmblemHealth

Claims Review Analyst

New York, NY · On-site

$48K - $83K/yr

Review and analyze suspected underpaid and overpaid claims from hospital, ancillary, and provider groups based on contractual and industry guidelines. * Identify and analyze single issues and trends ...

EmblemHealth

Claims Review Analyst

New York, NY · On-site

Review and analyze suspected underpaid and overpaid claims from hospital, ancillary, and provider groups based on contractual and industry guidelines. * Identify and analyze single issues and trends ...

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How much do claims review jobs pay per year?

As of Aug 7, 2026, the average yearly pay for claims review in the United States is $61,600.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,000.00 and $65,500.00 per year, depending on experience, location, and employer.

What does a claims review do?

A claims review involves examining insurance claims to verify their accuracy, completeness, and compliance with policy terms. Claims reviewers assess documentation, determine claim validity, and identify potential errors or fraud, often using specialized software and industry knowledge. This process helps ensure proper claim processing and cost control for insurance companies.

Is claims review processing a stressful job?

Claims review is a detail-oriented role that can be stressful due to tight deadlines, high accuracy requirements, and the need to interpret complex policies. It often involves managing large volumes of claims and making critical decisions, which can contribute to job stress, especially during busy periods or when handling difficult cases.

What is the difference between Claims Review vs Claims Adjuster?

AspectClaims ReviewClaims Adjuster
CredentialsTypically requires insurance or claims processing certificationsRequires similar certifications, often with licensing depending on state
Work EnvironmentMostly office-based, reviewing claims electronically or on paperField and office-based, inspecting damages and interviewing claimants
Employer & IndustryInsurance companies, third-party administratorsInsurance companies, public adjusters, third-party administrators
Search & Comparison IntentOften compared for claims processing rolesRelated but involves more investigation and assessment

Claims Review specialists focus on evaluating insurance claims for accuracy and completeness, primarily working in an office setting. Claims Adjusters, on the other hand, investigate claims, assess damages, and determine payouts, often working in the field. Both roles require similar certifications and are integral to the insurance industry, but they differ in responsibilities and work environment.

Do you need a degree to be a claims review?

A degree is not always required to become a claims reviewer, but many employers prefer candidates with a high school diploma or equivalent. Relevant skills include attention to detail, knowledge of insurance policies, and experience with claims processing software; some roles may offer on-the-job training or certification programs.
More about Claims Review jobs
What cities are hiring for Claims Review jobs? Cities with the most Claims Review job openings:
What states have the most Claims Review jobs? States with the most job openings for Claims Review jobs include:
Claims Review jobs near you
Infographic showing various Claims Review 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 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $61,600 per year, or $29.6 per hour.

Claims Review Specialist

Amwins

Scottsdale, AZ

Full-time

Re-posted 7 days ago

Amwins rating

7.8

Company rating: 7.8 out of 10

Based on 38 frontline employees who took The Breakroom Quiz

189th of 303 rated insurance

Job description

Join Our Team as a Claims Review Specialist at Amwins Self-Funded, LLC!

Are you ready to make a meaningful impact in the dynamic world of insurance? Join Amwins Self-Funded, LLC., as a Claims Review Specialist. This is an in-office position, that offers the flexibility to work from home up to 2 days a week after completing training.

Why Choose Amwins?

At Amwins, we value our team members and offer a range of benefits to enhance your work experience:

  • Flexibility: Enjoy a hybrid work environment with flexible scheduling options.
  • Comprehensive Benefits: Access a competitive benefits package from day one, including generous Paid Time Off (PTO) and paid holidays.
  • Continual Learning: Thrive in a collaborative, education-focused work environment.
  • Annual Bonus Program: Earn incentives through our performance-based bonus program, designed to reward you for achieving key goals and contributing to the company's success.

Learn more about us at amwins.com/benefits.

Responsibilities:

  • Learn Stealth's Business Model: Understand Amwins Self-Funded business model and the products we support under the guidance of the Claims Manager and Lead Claims Auditor.
  • Effective Correspondence: Correspond accurately and timely with carriers, administrators, clients, and brokers using approved form letters and emails, with all correspondence copied to the Claims Lead.
  • Claim Reports Management: Manage monthly claim reports for the administration of the assigned book of business, ensuring forwarding to the appropriate carrier and following up on missing reports.
  • Reimbursement Request Review: Review submitted reimbursement requests for completeness and request any missing information.
  • Eligibility Documentation Approval: Obtain approval from the Claims Lead on eligibility documentation noting time-off exceeding twelve (12) weeks before submitting a claim reimbursement request.
  • Claim Submission and Tracking: Record and submit reimbursement requests to the appropriate carrier within authorized dollar authority, tracking and following up on outstanding payments.
  • Reimbursement Issuance: Review and issue reimbursements, notifying designated contacts accurately and in a timely manner.
  • Claim Tracking Logs: Maintain internal claim tracking logs to ensure accurate records.
  • Year-End Account Closure: Manage the settlement of all reimbursement requests at the end of the plan year to properly close the client's account.
  • Adaptability and Team Collaboration: Handle other duties and projects as assigned, showcasing adaptability and strong collaboration skills.

Qualifications

  • Education and Experience: A college degree or equivalent work experience is strongly preferred.
  • Tech Proficiency: Proficiency with Microsoft Office products (Word, Excel, Outlook, and Teams) is preferred.
  • Critical Thinking: The ability to critically think and problem-solve.
  • Confidentiality: Ability to maintain strict confidentiality.
  • Organizational Skills: Ability to multitask, adjust to changing priorities, and effectively manage time to meet deadlines.
  • Communication Skills: Effective written and verbal communication skills with both internal and external parties.
  • Attention to Detail and Urgency: A sense of urgency and attention to detail are necessities.
  • Eager to Learn: Eagerness to learn Stealth's business model is a necessity.

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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