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Claims Reviewer Jobs (NOW HIRING)

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 DME.

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 DME.

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 A ...

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 A ...

The Bar Plan

Claims Attorney

Saint Louis, MO

Review and pay defense counsel fees and expenses. * Prepare reports and supervise defense counsel ... Keep Claims Vice President informed of all significant developments on assigned claims ...

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 ...

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Claims Reviewer information

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$30.5K

$64.6K

$90K

How much do claims reviewer jobs pay per year?

As of Jul 21, 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.

Is a claims examiner a stressful job?

A claims examiner role can be stressful due to the need for accuracy, attention to detail, and meeting deadlines while reviewing insurance claims. The job often involves handling complex cases and making critical decisions, which can contribute to work-related stress, especially during high workload periods or when dealing with difficult claimants.

What does a claims reviewer do?

A claims reviewer evaluates insurance claims to determine their validity and ensure they comply with policy terms. They analyze documentation, verify information, and make decisions on claim approval or denial, often using specialized software and adhering to company guidelines. Strong attention to detail and knowledge of insurance policies are essential for this role.

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.

How to get a job as a reviewer?

To become a claims reviewer, candidates typically need a high school diploma or equivalent, with some roles requiring a bachelor's degree in a related field. Relevant skills include attention to detail, analytical thinking, and knowledge of insurance policies or claims processing software. Gaining experience through internships or entry-level positions can improve chances, and certifications such as the Certified Claims Professional (CCP) may enhance qualifications.

How to get a job as a claims examiner?

To become a claims examiner, candidates typically need a high school diploma or equivalent, with some roles requiring a bachelor's degree in fields like insurance, business, or healthcare. Relevant skills include attention to detail, analytical thinking, and knowledge of insurance policies; obtaining certifications such as the Certified Claims Examiner (CCE) can improve job prospects. Experience in customer service or administrative roles can also be beneficial when applying for claims examiner positions.
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Claims Reviewer jobs near you
Infographic showing various Claims Reviewer job openings in the United States as of July 2026, with employment types broken down into 91% Full Time, 7% Part Time, and 2% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $64,609 per year, or $31.1 per hour.

Claims Specialist

CorVel Enterprise Claims, Inc.

Charlotte, NC • Remote

$52K - $85K/yr

Full-time

Posted 6 days ago

Job description

The Claims Specialist manages within company best practices low to mid Auto and/or General Liability claims, including bodily injury and property damage within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.

This is a remote role.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Receives auto and general liability claims, confirms policy coverage and acknowledgment of the claim
  • Determines validity and compensability of the claim
  • Establishes reserves and authorizes payments within reserving authority limits
  • Manages non-complex auto and general liability claims under close supervision
  • Communicates claim status with the customer, claimant and client
  • Adheres to client and carrier guidelines and participates in claims review as needed
  • Assists other claims professionals with more complex or problematic claims as necessary
  • Additional projects and duties as assigned

KNOWLEDGE & SKILLS:

  • Excellent written and verbal communication skills
  • Ability to learn rapidly to develop knowledge and understanding of claims practice
  • Ability to identify, analyze and solve problems
  • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
  • Strong interpersonal, time management and organizational skills
  • Ability to meet or exceed performance competencies
  • Ability to work both independently and within a team environment

EDUCATION & EXPERIENCE:

  • Bachelor's degree or a combination of education and related experience
  • Minimum of 1 year of industry experience and claims management preferred

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $52,999 – $85,473

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL:

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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