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Claims Tester Jobs (NOW HIRING)

KHS

Claims Trainer

Bakersfield, CA · On-site

$28.62 - $36.49/hr

The Claims Trainer is responsible for the direct training of the Claim Examiner staff ... Facilitate classroom style training for new hires that would include a curriculum and testing, as ...

Inceed

Medical Claims Specialist

Tulsa, OK · On-site

$18 - $20/hr

You'll support testing efforts for a new QNXT system, helping ensure member benefits, provider ... Review claims-related processes for accuracy. * Support testing in the QNXT system. * Verify member ...

Inceed

Medical Claims Specialist

Tulsa, OK · On-site

$18 - $20/hr

You'll support testing efforts for a new QNXT system, helping ensure member benefits, provider ... Review claims-related processes for accuracy. * Support testing in the QNXT system. * Verify member ...

CogniSoft Technologies

System Analyst II

Detroit, MI · On-site

NASCO 3270 Mainframe Medical Claims (Professional & Facility) NASCO Classic Group Benefits Claims Testing & Business Requirements Bachelor''s degree preferred with 3+ years of relevant experience. If ...

Sigma Systems, Inc.

Claims Examiner

Irving, TX

Solve moderately complex claims and escalate issues to the Claims Team Lead, Supervisor or Manager. * Assist with database improvements and testing for system upgrades, conversions, or implementation ...

System One

Healthcare Claims Specialist

Tulsa, OK · On-site

$18 - $20/hr

Execute system and user acceptance testing (UAT) during implementation. * Validate member benefits, eligibility, and claims processing. * Verify claims adjudication accuracy and provider contract ...

System One

Healthcare Claims Specialist

Tulsa, OK · On-site

$18 - $20/hr

Execute system and user acceptance testing (UAT) during implementation. * Validate member benefits, eligibility, and claims processing. * Verify claims adjudication accuracy and provider contract ...

System One

Healthcare Claims Specialist

Tulsa, OK · On-site

$18 - $20/hr

Execute system and user acceptance testing (UAT) during implementation. * Validate member benefits, eligibility, and claims processing. * Verify claims adjudication accuracy and provider contract ...

Rylem Staffing

Senior Claims Examiner

Irving, TX · On-site

The Claims Examiner Senior is responsible for reviewing, analyzing, researching, and resolving ... testing for system upgrades, conversions, or implementation of new processes.

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Claims Tester information

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$41K

$76K

$99K

How much do claims tester jobs pay per year?

As of Jul 14, 2026, the average yearly pay for claims tester in the United States is $76,039.00, according to ZipRecruiter salary data. Most workers in this role earn between $66,000.00 and $85,500.00 per year, depending on experience, location, and employer.

What jobs pay 500,000 a year in the US?

Claims testers typically do not earn $500,000 annually; such high salaries are usually found in executive roles, specialized medical professionals, or successful entrepreneurs. High-paying jobs often require advanced skills, certifications, or significant experience. For claims testers, top salaries may reach six figures with extensive experience or managerial responsibilities, but $500,000 is uncommon in this role.

Is there a legit product tester job?

A claims tester is a legitimate role that involves evaluating insurance claims, often requiring attention to detail and knowledge of insurance processes. Genuine product testing jobs, which involve testing physical or digital products, are different and typically require specific skills or experience. It's important to verify job postings to avoid scams and ensure the role matches your skills and interests.

What are some common challenges faced by Claims Testers, and how can they be addressed?

Claims Testers often encounter challenges such as working with complex insurance systems, adapting to frequently changing regulations, and ensuring test cases accurately reflect real-world claim scenarios. Effective communication with developers, business analysts, and claims processors is essential to clarify requirements and resolve discrepancies. To address these challenges, it's helpful to stay updated on industry standards, participate in regular team meetings, and continually refine testing processes based on feedback and observed outcomes.

What is the difference between Claims Tester vs Claims Analyst?

AspectClaims TesterClaims Analyst
Required CertificationsBasic knowledge of insurance and testing certificationsInsurance certifications often preferred, such as CPCU or AIC
Work EnvironmentQuality assurance teams, testing labs, or IT departmentsClaims departments within insurance companies or third-party administrators
Employer & Industry UsageInsurance companies, software vendors, and consulting firmsInsurance carriers, third-party claims processors, and brokers
Common Search & Comparison IntentUnderstanding testing roles in claims processingAnalyzing claims data and processing efficiency

Claims Testers focus on testing insurance claim systems and ensuring software quality, while Claims Analysts evaluate and process insurance claims to determine coverage and payouts. Both roles are essential in the claims process but differ in their primary functions and skill sets.

What company pays you to test their products?

Claims testers are typically employed by insurance companies or third-party testing firms that evaluate insurance claims. They are paid to review and verify claims, often requiring knowledge of insurance policies and claims processing procedures.

What are the key skills and qualifications needed to thrive as a Claims Tester, and why are they important?

To thrive as a Claims Tester, you need a strong understanding of insurance claims processes, attention to detail, and experience with quality assurance or testing methodologies, often supported by a relevant degree or claims certification. Familiarity with claims management systems, test automation tools, and defect tracking software is typically required. Analytical thinking, effective communication, and problem-solving skills make someone stand out in this role. These competencies are crucial for ensuring the accuracy and compliance of claims processing systems, which directly impact customer satisfaction and organizational integrity.

What are Claims Testers?

Claims Testers are professionals who evaluate and verify insurance claims to ensure they meet company policies and regulatory requirements. Their primary responsibility is to test claims processing systems, review claim documents, and identify errors or inconsistencies before claims are approved or denied. Claims Testers work closely with claims adjusters and system developers to improve accuracy and efficiency in the claims process. They play a crucial role in maintaining the integrity of an insurance company's claims operations.

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 an associate's or 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 Professional (CCP) can improve job prospects. Experience in customer service or administrative roles can also be beneficial when applying for claims examiner positions.
More about Claims Tester jobs
What are the most commonly searched types of Claims Tester jobs? The most popular types of Claims Tester jobs are:
What job categories do people searching Claims Tester jobs look for? The top searched job categories for Claims Tester jobs are:
Claims Tester jobs near you
Infographic showing various Claims Tester 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 $76,039 per year, or $36.6 per hour.
Information Technology_USA - USA_Developer

Information Technology_USA - USA_Developer

Real Soft, Inc.

Jacksonville, FL • On-site

Contractor

Re-posted 12 days ago

Job description

Must Have Technical/Functional Skills
• Strong SME knowledge in Healthcare Claims Processing lifecycle
• Expertise in EDI formats - 837 (P/I/D), 835, 834
• Hands-on experience in Facets (Claims + Enrollment modules)
• Proficiency in Azure DevOps (ADO) for QA tracking
• Knowledge of HIPAA compliance and payer systems
• 8+ years of experience in Healthcare QA/Testing
• 4+ years of experience as Test Lead in Facets projects
• Deep understanding of Claims Adjudication & Payment workflows
• Experience in handling claims denials, adjustments, and reprocessing
• Strong exposure to EDI claim and remittance transactions
• Experience in mocking and validating EDI files (837/835/834)
• Knowledge of ITS claims processing (SF, DF, RF)
• Experience in Member Enrollment workflows (Medicaid, Medicare, ACA)
• Understanding of Billing lifecycle for member enrollment
• Hands-on experience with ADO Test Plans, Test Suites, and Defect tracking
• Ability to perform data validation and reconciliation activities
• Strong experience in functional and end-to-end testinG
Familiarity with Agile/Scrum methodologies • Excellent stakeholder communication and coordination skills • Experience in risk identification, defect triage, and RCA
Roles & Responsibilities
• Lead end-to-end testing for Claims, Enrollment, and Billing modules
• Act as SME for Claims Processing and EDI transactions
• Validate Facets Claims and Membership workflows
• Design and execute test strategies, test plans, and test cases
• Perform EDI validation (837, 835, 834) including mock data creation
• Manage defect lifecycle, triage, and resolution tracking in ADO
• Ensure HIPAA compliance in all testing activities
• Validate ITS claims processing across SF, DF, RF flows
• Drive quality metrics, reporting, and release sign-offs
• Collaborate with business, development, and partner teams for E2E validation
Generic Managerial Skills, If any
• Leading and Mentoring team members
• Strong problem-solving and critical thinking
• Ability to work with minimal supervision
• Documentation and knowledge sharing
• Excellent communication
Key Words to search in Resume
• EDI claims
• EDI files (837 , 835, 834)
• Facets
• Claims
• Member Enrollment
• Billing lifecycle
• Azure DevOps (ADO)
• HIPAA compliance
• Healthcare QA, Testing
• Test Lead
• Claims Adjudication
• Payment workflows
• ITS
Pre-Screening Questionnaire
• Do you have 7+ years of Healthcare QA/Testing experience?
• Do you have experience as a QA/Test lead , leading and mentoring team members?
• Do you have experience with Facets including Claims, Enrollment, and Billing modules?
• Do you have experience in EDI validation (837, 835, 834) including mock data creation?
• Do you have experience in Claims Processing ?
• Do you have experience in ITS claims processing ?
• Have you managed defect lifecycle, triage, and resolution tracking in ADO?
• Have you been responsible for quality metrics, reporting, and release sign-offs?
• Have you collaborated with business, development, and partner teams for E2E validation?
*What are Regulated Positions
"Regulated Positions" are those positions which requires TAG to recruit candidates with specific work
authorizations viz., US Citizens (or) US Persons only as these may be regulated by any of the below listed
per MSA.
- ITAR (International Traffic in Arms Regulations).
- NERC CIP (NERC Critical Infrastructure Protection).
- NRC (Nuclear Regulatory Commission).
- Any other regulations as appropriate.
Role Descriptions: Functional testingFacets Claims testing Pricing claims and Alliance claim pricing testing SQL/DB testing| Automation
Essential Skills: Functional testingFacets Claims testing Pricing claims and Alliance claim pricing testing SQL/DB testing| Automation
Desirable Skills:
Keyword:
Skills: Functional Testing
Experience Required: 8-10, Project Code :

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