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Claims Tester Jobs (NOW HIRING)

Port Houston

Claims Services Manager

Houston, TX · On-site

Administrate procedural reporting process for post-accident drug testing, to include vendor ... Associate in Claims (AIC), Risk Management (ARM) and/or Certified Property Casualty Underwriter ...

New Mexico Mutual

Claims Specialist

Albuquerque, NM · On-site

Claims Specialist Department: Claims Reports To: Claims Manager Position Summary: This position ... NEW MEXICO MUTUAL maintains a drug free environment; drug testing prior to employment as well as ...

Port Houston

Claims Services Manager

Houston, TX · On-site

Administrate procedural reporting process for post-accident drug testing, to include vendor ... Associate in Claims (AIC), Risk Management (ARM) and/or Certified Property Casualty Underwriter ...

PYRAMID TECHNOLOGIES

IT Tester/ QA analyst

Woodland, CA · On-site

... claims applications, Compatibility testing with existing claims applications to make sure no impact by updating the new software/Image ,drivers etc.. This Individual Develops, documents, executes ...

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How much do claims tester jobs pay per year?

As of Jun 7, 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 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 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.
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 May 2026, with employment types broken down into 77% Full Time, 10% Part Time, and 13% Contract. Highlights an 84% In-person, 3% Hybrid, and 13% Remote job distribution, with an average salary of $76,039 per year, or $36.6 per hour.
Claims Trainer

Claims Trainer

Partnership HealthPlan of California

Fairfield, CA • On-site

Full-time

Posted 11 days ago

Job description

Overview

Train examiner and customer service level I staff on all related claim types for all Partnership lines of business using AMISYS Advance system and Claims Operating Instruction Memorandums.

Responsibilities
  • Train all levels of staff on all claim types on-site or regional site(s).
  • Train all levels of staff on CIF processing, generating and processing adjustments both on-site and regional site(s)
  • Provide feedback and recommendation to the Claims Audit Supervisor and Associate Director of Claims on staff training needs and system adjustments.
  • Create and maintain training materials
  • Maintain current knowledge of Partnerhsip Claims Policy and Procedures for all lines of business, Medi-Cal Provider Manual, Title 22 regulations, Knox Keene regulations, and CMS Medicare regulations.
  • Draft Claims Operating Instruction documentation for the Claims Director as assigned.

SECONDARY DUTIES AND RESPONSIBILITIES

  • Assist with system testing as needed.
  • Other duties as assigned.
Qualifications

Education and Experience

Minimum two (2) years of claims examining experience and completion of Partnership Claims training; or equivalent combination of education the experience.

 

 

Special Skills, Licenses and Certifications

Familiar with Medi0Cal and/or managed care claims processing. Knowledge of CPT, HCPC procedure coding, and ICD -9/ICD10 diagnostic coding. Typing speed 30 wpm and proficient use of 10-key calculator. Familiar with AMISYS or similar claims systems. Understanding of claims examining requirements. Valid California driver's license and proof of current automobile insurance compliant with Partnerrship policy are required to operate a vehicle and travel for company business.

 

Performance Based Competencies

Excellent oral and written communication skills. Ability to effectively exercise good judgment within scope of authority and handle sensitive issues with tact and diplomacy. Ability to work on multiple tasks within established time frames and sometimes conflicting priorities. Good organizational skills with ability to maintain accurate records and documentation of actions and decisions.

Work Environment And Physical Demands

Ability to use a computer keyboard. More than 60% of work time is spent in front of a computer monitor. When required, ability to move, carry or list objects of varying size, weighing up to 5 lbs.

All HealthPlan employees are expected to:

  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the HealthPlan's policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$32.51 - $39.01

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Employment Type: FULL_TIME

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