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Claims Reviewer Jobs (NOW HIRING)

TEEMA

Claims Reviewer

Phoenix, AZ · Remote

$25 - $29/hr

Claims Reviewer Job ID: 75861 Location : Arizona - Remote What you will be doing: * Conducts medical claims review using current claims processing guidelines and established clinical criteria e.g.

TEEMA

Claims Reviewer

Phoenix, AZ · Remote

$26.40 - $27.88/hr

Claims Reviewer Opportunity Join a dynamic team where your expertise in claims review can make a real difference! We're looking for a detail-oriented Claims Reviewer who can apply clinical and coding ...

Trustpoint.One

Claims Reviewer

Richmond, VA · On-site

$23/hr

Trustpoint.One is hiring Claims Reviewers for a temporary project ln Richmond, Virginia. This position will start in June 2026 and is anticipated to last 3 months. This is a temporary job.

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 ...

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 ...

Empower AI Inc.

Perform comprehensive medical record and claims review to make payment determinations based on Insurance coverage, coding, and utilization of services and practice guidelines for Medicare DRG.

Empower AI Inc.

Perform comprehensive medical record and claims review to make payment determinations based on Insurance coverage, coding, and utilization of services and practice guidelines for Medicare DRG.

Empower AI Inc.

Perform comprehensive medical record and claims review to make payment determinations based on Insurance coverage, coding, and utilization of services and practice guidelines for Medicare DRG.

Empower AI Inc.

Perform comprehensive medical record and claims review to make payment determinations based on Insurance coverage, coding, and utilization of services and practice guidelines for Medicare DRG.

Metlife Legal Plans

Director, Claims Counsel

Cleveland, OH · On-site

$130K - $165K/yr

Review, adjudicate, and approve complex and high‑value claims, including approvals, rejections, and adjustments, in accordance with approved fee schedules and coverage determinations * Primary ...

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How much do claims reviewer jobs pay per year?

As of Jun 8, 2026, the average yearly pay for claims reviewer in the United States is $64,609.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,000.00 and $75,500.00 per year, depending on experience, location, and employer.

What are the common daily responsibilities for a Claims Reviewer, and what does a typical workday look like?

As a Claims Reviewer, your typical day involves evaluating insurance claims to determine their validity, reviewing supporting documents, and making recommendations for approval or denial based on policy guidelines. You will often collaborate with team members, adjusters, and occasionally interact with clients or healthcare providers to obtain additional information or clarification. The role frequently requires balancing multiple cases simultaneously while adhering to strict deadlines and maintaining high accuracy. Most Claims Reviewers work in an office setting, but some companies also offer remote or hybrid options, making the work environment flexible. This position offers the opportunity to develop expertise in insurance practices and can lead to advancement into supervisory or specialized claims roles.

What is a Claims Reviewer job?

A Claims Reviewer evaluates insurance claims to determine their validity and ensures they comply with company policies and regulations. They analyze documentation, verify details, and may consult with medical or industry experts. Their role helps prevent fraud, control costs, and ensure fair compensation for policyholders. Strong attention to detail and knowledge of insurance policies are essential for this role.

What are the key skills and qualifications needed to thrive in the Claims Reviewer position, and why are they important?

To thrive as a Claims Reviewer, you need a solid understanding of insurance policies, claim evaluation procedures, and strong analytical skills, often supported by a degree in a related field or equivalent experience. Familiarity with claims management software, electronic documentation systems, and knowledge of relevant regulations or coding (such as ICD or CPT) is typically required. Attention to detail, critical thinking, and effective written and verbal communication are essential soft skills in this position. These skills are vital for accurately assessing claims, ensuring compliance, and maintaining efficiency in a detail-oriented, deadline-driven environment.

More about Claims Reviewer jobs
What cities are hiring for Claims Reviewer jobs? Cities with the most Claims Reviewer job openings:
What are the most commonly searched types of Claims Reviewer jobs? The most popular types of Claims Reviewer jobs are:
Who are the top companies hiring for Claims Reviewer jobs? The top employers for Claims Reviewer jobs are:
What states have the most Claims Reviewer jobs? States with the most job openings for Claims Reviewer jobs include:
What job categories do people searching Claims Reviewer jobs look for? The top searched job categories for Claims Reviewer jobs are:
Claims Reviewer jobs near you
Infographic showing various Claims Reviewer job openings in the United States as of May 2026, with employment types broken down into 82% Full Time, and 18% Contract. Highlights an 65% In-person, 6% Hybrid, and 29% Remote job distribution, with an average salary of $64,609 per year, or $31.1 per hour.
Claims Reviewer

Claims Reviewer

TEEMA

Phoenix, AZ • Remote

$25 - $29/hr

Full-time

Posted 6 days ago

Job description


Job Tittle: Claims Reviewer
Job ID: 75861
Location: Arizona - Remote
What you will be doing:

  • Conducts medical claims review using current claims processing guidelines and established clinical criteria e.g. CDST and policy keys, to evaluate medical necessity, appropriateness of care and program benefits, exclusions and limitations.

  • Validates medical determinations through research of resources including regulatory manuals, computer files, and documentation.

  • Prepares cases program payment or medical director review as indicated.

  • Validates all appropriate data is supplied with program invoice.

  • Reviews claim data for process improvements related to all aspects of claims payment.

  • Ensures contract compliance for timelines regarding resolution of medical claims.

  • Communicates effectively with management and peers.

  • Consistently meets medical claims processing quotas.

  • Identifies and reports any potential quality or fraud issues to management, Quality Management, or Program Integrity as needed.

  • Provides support regarding clinical and coding questions.

  • Performs other duties as assigned.

  • Regular and reliable attendance is required.


What you must have:

  • High School Diploma or GED

  • 2+ years of claims review experience

  • Knowledge of all types of Medical claims review


Nice to have:

  • Claim coding experience

  • Knowledge of behavioral health claims review


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About Teema

Sourced by ZipRecruiter

TEEMA is an award-winning, industry-leading recruitment agency dedicated to building meaningful relationships across North America. We achieve this time after time by consistently sourcing, screening, managing and securing top talent tailored to employers’ specific needs. The team that makes this happen consists of hundreds of experienced professional recruiters backed by exceptional, tenured leadership and back-office support. No matter how unique or challenging your hiring needs may be or how misunderstood or undervalued your in-demand skills may be in your current role, we have you covered. Our primary objective is to provide an exceptional recruitment experience for our clients and candidates and an ecosystem that empowers our team to thrive.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Litchfield Park, AZ, US

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