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.
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.
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.
$43K - $85K/yr
The Claims Reviewer is responsible for reviewing pharmacy claims submitted through the CVS Health claims processing systems. The Claims Reviewer will identify and rectify claim inaccuracies that ...
$43K - $85K/yr
The Claims Reviewer is responsible for reviewing pharmacy claims submitted through the CVS Health claims processing systems. The Claims Reviewer will identify and rectify claim inaccuracies that ...
Hi, Our client is looking for an Physician ED Claims Reviewer Role for Remote below is the detailed requirement. Job Title: Physician ED Claims Reviewer Location: Remote * Bachelor's degree in ...
New
Hi, Our client is looking for an Physician ED Claims Reviewer Role for Remote below is the detailed requirement. Job Title: Physician ED Claims Reviewer Location: Remote * Bachelor's degree in ...
New
Prosper, TX · On-site
$201K - $239K/yr
Physician ED Claims Reviewer Duration: 12 months Required skills: Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review ...
Prosper, TX · On-site
$201K - $239K/yr
Physician ED Claims Reviewer Duration: 12 months Required skills: Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review ...
Prosper, TX · Remote
$225K - $267K/yr
Physician ED Claims Reviewer Duration: 12 months Required skills: Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review ...
Quick apply
Prosper, TX · Remote
$225K - $267K/yr
Physician ED Claims Reviewer Duration: 12 months Required skills: Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review ...
OR · Remote
Review medically complex claims , pre-authorization requests, appeals, and fraud/abuse referrals. * Assess payment determinations using clinical information and established guidelines. * Evaluate ...
OR · Remote
Review medically complex claims , pre-authorization requests, appeals, and fraud/abuse referrals. * Assess payment determinations using clinical information and established guidelines. * Evaluate ...
Overview Advanced Technologies & Laboratories International, Inc. (ATL) is hiring a Claims Auditor, Reviewer and Coder. The Contractor shall provide expertise in quality assurance, claims processing ...
Overview Advanced Technologies & Laboratories International, Inc. (ATL) is hiring a Claims Auditor, Reviewer and Coder. The Contractor shall provide expertise in quality assurance, claims processing ...
Overview Advanced Technologies & Laboratories International, Inc. (ATL) is hiring a Claims Auditor, Reviewer and Coder. The Contractor shall provide expertise in quality assurance, claims processing ...
Overview Advanced Technologies & Laboratories International, Inc. (ATL) is hiring a Claims Auditor, Reviewer and Coder. The Contractor shall provide expertise in quality assurance, claims processing ...
Overview Advanced Technologies & Laboratories International, Inc. (ATL) is hiring a Claims Auditor, Reviewer and Coder. The Contractor shall provide expertise in quality assurance, claims processing ...
Overview Advanced Technologies & Laboratories International, Inc. (ATL) is hiring a Claims Auditor, Reviewer and Coder. The Contractor shall provide expertise in quality assurance, claims processing ...
Charleston, WV · On-site
... claims ... Reviewer must meet or exceed production and quality standards and follow documented policies and ...
Quick apply
Charleston, WV · On-site
... claims ... Reviewer must meet or exceed production and quality standards and follow documented policies and ...
Wheeling, WV · On-site
... claims ... Reviewer must meet or exceed production and quality standards and follow documented policies and ...
Quick apply
Wheeling, WV · On-site
... claims ... Reviewer must meet or exceed production and quality standards and follow documented policies and ...
Pharmacy Technician - Claims Review Specialist Pharmacy Technician - Claims Review Specialist What's your wish list for the perfect job? Maybe it's to make a positive impact in the world, or to grow ...
Pharmacy Technician - Claims Review Specialist Pharmacy Technician - Claims Review Specialist What's your wish list for the perfect job? Maybe it's to make a positive impact in the world, or to grow ...
San Diego, CA · On-site
$18 - $32/hr
Healthcare Claims Reviewer Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve ...
New
San Diego, CA · On-site
$18 - $32/hr
Healthcare Claims Reviewer Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve ...
New
San Diego, CA · On-site
$18 - $32/hr
Healthcare Claims Reviewer Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve ...
New
San Diego, CA · On-site
$18 - $32/hr
Healthcare Claims Reviewer Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve ...
New
Harrisburg, PA · On-site
$56K - $60K/hr
We are seeking an experienced Claims Review Management Nurse (RN) to support the Pennsylvania Medicaid program in a long-term, full-time contract role based in Harrisburg, PA, with a hybrid schedule ...
Quick apply
Harrisburg, PA · On-site
$56K - $60K/hr
We are seeking an experienced Claims Review Management Nurse (RN) to support the Pennsylvania Medicaid program in a long-term, full-time contract role based in Harrisburg, PA, with a hybrid schedule ...
We are seeking an experienced Claims Review Management Nurse (RN) to support the Pennsylvania Medicaid program in a long-term, full-time contract role based in Harrisburg, PA, with a hybrid schedule ...
We are seeking an experienced Claims Review Management Nurse (RN) to support the Pennsylvania Medicaid program in a long-term, full-time contract role based in Harrisburg, PA, with a hybrid schedule ...
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 ...
Quick apply
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 ...
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 ...
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 ...
Overview Pharmacy Technician - Claims Review Specialist What's your wish list for the perfect job? Maybe it's to make a positive impact in the world, or to grow your career in healthcare. Maybe ...
Overview Pharmacy Technician - Claims Review Specialist What's your wish list for the perfect job? Maybe it's to make a positive impact in the world, or to grow your career in healthcare. Maybe ...
Overview Pharmacy Technician - Claims Review Specialist What's your wish list for the perfect job? Maybe it's to make a positive impact in the world, or to grow your career in healthcare. Maybe ...
Overview Pharmacy Technician - Claims Review Specialist What's your wish list for the perfect job? Maybe it's to make a positive impact in the world, or to grow your career in healthcare. Maybe ...
$30.5K - $35.9K
1% of jobs
$35.9K - $41.3K
3% of jobs
$41.3K - $46.7K
5% of jobs
$51.5K is the 25th percentile. Wages below this are outliers.
$46.7K - $52.1K
17% of jobs
$52.1K - $57.5K
11% of jobs
The median wage is $62.3K / yr.
$57.5K - $63K
14% of jobs
$63K - $68.4K
13% of jobs
$73.6K is the 75th percentile. Wages above this are outliers.
$68.4K - $73.8K
11% of jobs
$73.8K - $79.2K
10% of jobs
$79.2K - $84.6K
9% of jobs
$84.6K - $90K
6% of jobs
$30.5K
$64.6K
$90K
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.
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.
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.

Sourced by ZipRecruiter
Law firms
51 - 200 Employees
Atlanta, GA, US
2009