Claims Repricer
Philadelphia, PA · On-site
Analyze pricing discrepancies and perform adjustments to align with contractual and system ... Validate contract terms and ensure proper interpretation within claims adjudication systems
Claims Repricer
Philadelphia, PA · On-site
Analyze pricing discrepancies and perform adjustments to align with contractual and system ... Validate contract terms and ensure proper interpretation within claims adjudication systems
AVP Claims & Configuration - REMOTE
Home, WA · Remote
$164K - $279K/yr
Lead cross-functional teams responsible for claims adjudication, benefit configuration, testing ... contractual requirements and internal policies and procedures Every employee must be able to ...
AVP Claims & Configuration - REMOTE
Home, WA · Remote
$164K - $279K/yr
Lead cross-functional teams responsible for claims adjudication, benefit configuration, testing ... contractual requirements and internal policies and procedures Every employee must be able to ...
Supervisor, Provider Network Management
Phoenix, AZ · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Ensures the team meets contractual response times, quality standards, and provider satisfaction ... receive a favorable Interim and adjudicated final Department of Defense (DoD) background ...
Supervisor, Provider Network Management
Phoenix, AZ · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Ensures the team meets contractual response times, quality standards, and provider satisfaction ... receive a favorable Interim and adjudicated final Department of Defense (DoD) background ...
MSO CLAIMS MANAGER
Burlingame, CA · On-site
$112K - $128K/yr
Medical
Dental
Vision
Retirement
... contractual obligations. The Claims Manager will lead the claims team, implement process improvements, and collaborate with internal and external stakeholders to optimize claims adjudication ...
MSO CLAIMS MANAGER
Burlingame, CA · On-site
$112K - $128K/yr
Medical
Dental
Vision
Retirement
... contractual obligations. The Claims Manager will lead the claims team, implement process improvements, and collaborate with internal and external stakeholders to optimize claims adjudication ...
MSO CLAIMS MANAGER
Burlingame, CA · On-site
Medical
Dental
Vision
Retirement
... contractual obligations. The Claims Manager will lead the claims team, implement process improvements, and collaborate with internal and external stakeholders to optimize claims adjudication ...
MSO CLAIMS MANAGER
Burlingame, CA · On-site
Medical
Dental
Vision
Retirement
... contractual obligations. The Claims Manager will lead the claims team, implement process improvements, and collaborate with internal and external stakeholders to optimize claims adjudication ...
MSO CLAIMS MANAGER
Burlingame, CA · On-site
Medical
Dental
Vision
Retirement
... contractual obligations. The Claims Manager will lead the claims team, implement process improvements, and collaborate with internal and external stakeholders to optimize claims adjudication ...
MSO CLAIMS MANAGER
Burlingame, CA · On-site
Medical
Dental
Vision
Retirement
... contractual obligations. The Claims Manager will lead the claims team, implement process improvements, and collaborate with internal and external stakeholders to optimize claims adjudication ...
Medical Coding Specialist II
Virginia Beach, VA · On-site +1
Medical
Dental
Vision
Life
Retirement
PTO
This role requires a comprehensive understanding of the entire billing cycle, including medical terminology, coding principles, charge entry, insurance adjudication, contractual agreements, payment ...
Medical Coding Specialist II
Virginia Beach, VA · On-site +1
Medical
Dental
Vision
Life
Retirement
PTO
This role requires a comprehensive understanding of the entire billing cycle, including medical terminology, coding principles, charge entry, insurance adjudication, contractual agreements, payment ...
Requirements/ Documentation Analyst
Mclean, VA · On-site
Medical
Dental
Vision
Life
Retirement
Track the digitization vendor's completion of contractual requirements in collaboration with the ... adjudication of their PUBLIC TRUST prior to onboarding with Guidehouse. Candidates with an ACTIVE ...
Quick apply
Requirements/ Documentation Analyst
Mclean, VA · On-site
Medical
Dental
Vision
Life
Retirement
Track the digitization vendor's completion of contractual requirements in collaboration with the ... adjudication of their PUBLIC TRUST prior to onboarding with Guidehouse. Candidates with an ACTIVE ...
Oversee the review and adjudication of traffic enforcement images in accordance with client ... Ensure all image processing activities comply with client SLAs, contractual obligations, and ...
Oversee the review and adjudication of traffic enforcement images in accordance with client ... Ensure all image processing activities comply with client SLAs, contractual obligations, and ...
... with contractual business rules. Performs claims data analysis and presents results and ... Provides data management support and creates custom reports to illustrate claim adjudication trends ...
... with contractual business rules. Performs claims data analysis and presents results and ... Provides data management support and creates custom reports to illustrate claim adjudication trends ...
Director, Claim Payment Accuracy
Medical
Dental
Vision
Retirement
Ensure that clinical intent, benefit design, and contractual terms are perfectly synchronized in the final payment adjudication. Success in this role looks like: * By the end of your initial 90-day ...
Director, Claim Payment Accuracy
Medical
Dental
Vision
Retirement
Ensure that clinical intent, benefit design, and contractual terms are perfectly synchronized in the final payment adjudication. Success in this role looks like: * By the end of your initial 90-day ...
... with contractual business rules. Performs claims data analysis and presents results and ... Provides data management support and creates custom reports to illustrate claim adjudication trends ...
... with contractual business rules. Performs claims data analysis and presents results and ... Provides data management support and creates custom reports to illustrate claim adjudication trends ...
Director, Claim Payment Accuracy
Medical
Dental
Vision
Retirement
Ensure that clinical intent, benefit design, and contractual terms are perfectly synchronized in the final payment adjudication. Success in this role looks like: * By the end of your initial 90-day ...
Director, Claim Payment Accuracy
Medical
Dental
Vision
Retirement
Ensure that clinical intent, benefit design, and contractual terms are perfectly synchronized in the final payment adjudication. Success in this role looks like: * By the end of your initial 90-day ...
Senior Product Manager - AI Transformation, UMR - Remote
Eden Prairie, MN · On-site +1
$129K - $170K/yr
Retirement
... claim adjudication efficiency, payment integrity, and operational accuracy. The Senior Product ... contractual compliance * Manage cross-workstream dependencies, integration points ...
Senior Product Manager - AI Transformation, UMR - Remote
Eden Prairie, MN · On-site +1
$129K - $170K/yr
Retirement
... claim adjudication efficiency, payment integrity, and operational accuracy. The Senior Product ... contractual compliance * Manage cross-workstream dependencies, integration points ...
Construction Claims Principal Expert
Golden, CO · On-site +1
$150K - $180K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Contractual Oversight: Reviewing contract terms (e.g., FIDIC, NEC, JCT) to identify entitlements ... Dispute Resolution (ADR) processes, including mediation, adjudication, and arbitration.
Quick apply
Construction Claims Principal Expert
Golden, CO · On-site +1
$150K - $180K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Contractual Oversight: Reviewing contract terms (e.g., FIDIC, NEC, JCT) to identify entitlements ... Dispute Resolution (ADR) processes, including mediation, adjudication, and arbitration.
Offshore Adjudication Oversight & Quality Enablement * Provide indirect oversight and technical ... Assess adherence to contractual requirements, repair practices, quality standards, and cost ...
Offshore Adjudication Oversight & Quality Enablement * Provide indirect oversight and technical ... Assess adherence to contractual requirements, repair practices, quality standards, and cost ...
Claims Examiner - Remote
Tampa, FL · Remote
Medical
Dental
Vision
Life
Retirement
PTO
... guidelines, contractual agreements, regulatory requirements, and internal policies ... Understanding of health claims processing/adjudication * Ability to perform basic to intermediate ...
Claims Examiner - Remote
Tampa, FL · Remote
Medical
Dental
Vision
Life
Retirement
PTO
... guidelines, contractual agreements, regulatory requirements, and internal policies ... Understanding of health claims processing/adjudication * Ability to perform basic to intermediate ...
Claims Examiner I
Manhattan, NY · Hybrid
$50K - $54K/yr
Position Overview The Claims Examiner I is responsible for the data entry and system adjudication ... Evaluates and examines claims pended by the system due to contractual and/or payment discrepancies
Claims Examiner I
Manhattan, NY · Hybrid
$50K - $54K/yr
Position Overview The Claims Examiner I is responsible for the data entry and system adjudication ... Evaluates and examines claims pended by the system due to contractual and/or payment discrepancies
Claims Examiner I
Manhattan, NY · On-site
$50K - $54K/yr
Position Overview The Claims Examiner I is responsible for the data entry and system adjudication ... Evaluates and examines claims pended by the system due to contractual and/or payment discrepancies
Claims Examiner I
Manhattan, NY · On-site
$50K - $54K/yr
Position Overview The Claims Examiner I is responsible for the data entry and system adjudication ... Evaluates and examines claims pended by the system due to contractual and/or payment discrepancies
Claims Examiner - Remote
Tampa, FL · On-site +1
Medical
Dental
Vision
Life
Retirement
PTO
... guidelines, contractual agreements, regulatory requirements, and internal policies ... Understanding of health claims processing/adjudication * Ability to perform basic to intermediate ...
Claims Examiner - Remote
Tampa, FL · On-site +1
Medical
Dental
Vision
Life
Retirement
PTO
... guidelines, contractual agreements, regulatory requirements, and internal policies ... Understanding of health claims processing/adjudication * Ability to perform basic to intermediate ...
Contractual Adjudication information
See salary details
$8.65 - $14.29
1% of jobs
$14.29 - $19.93
5% of jobs
$23.33 is the 25th percentile. Wages below this are outliers.
$19.93 - $25.57
31% of jobs
$25.57 - $31.21
12% of jobs
The median wage is $31.77 / hr.
$31.21 - $36.84
11% of jobs
$36.84 - $42.48
14% of jobs
$43.33 is the 75th percentile. Wages above this are outliers.
$42.48 - $48.12
11% of jobs
$48.12 - $53.76
1% of jobs
$53.76 - $59.40
4% of jobs
$59.40 - $65.03
9% of jobs
$65.03 - $70.67
2% of jobs
$8
$38
$70
How much do contractual adjudication jobs pay per hour?
As of Aug 18, 2026, the average hourly pay for contractual adjudication in the United States is $38.10, according to ZipRecruiter salary data. Most workers in this role earn between $23.80 and $45.19 per hour, depending on experience, location, and employer.
What is the difference between Contractual Adjudication vs Contract Administrator?
| Aspect | Contractual Adjudication | Contract Administrator |
|---|---|---|
| Credentials | Legal or contractual training, certifications in dispute resolution | Project management, contract management certifications |
| Work Environment | Legal, dispute resolution, or contractual review settings | Construction, engineering, or project management offices |
| Industry Usage | Legal and dispute resolution sectors | Construction, engineering, and project-based industries |
Contractual Adjudication focuses on resolving contractual disputes through legal or formal dispute processes, often involving legal expertise. Contract Administrators manage contract documentation, compliance, and coordination during project execution. While both roles deal with contracts, Adjudicators primarily resolve disputes, whereas Administrators oversee contract management throughout the project lifecycle.
More about Contractual Adjudication jobs
What cities are hiring for Contractual Adjudication jobs?
Cities with the most Contractual Adjudication job openings:
What are the most commonly searched types of Adjudication jobs?
The most popular types of Adjudication jobs are:
What states have the most Contractual Adjudication jobs?
States with the most job openings for Contractual Adjudication jobs include:
What job categories do people searching Contractual Adjudication jobs look for?
The top searched job categories for Contractual Adjudication jobs are:
Independence Blue Cross rating
8.8
Based on 26 frontline employees who took The Breakroom Quiz
57th of 309 rated insurance
Job description
Position Summary
The Claims Repricer is responsible for the accurate review, adjustment, and application of pricing methodologies to medical claims. This role ensures claims are priced in accordance with provider contracts, fee schedules, and benefit structures. The position plays a critical role in maintaining pricing integrity, minimizing rework, and supporting operational efficiency in a high-volume claims environment.
Key Responsibilities
Required Qualifications
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
The Claims Repricer is responsible for the accurate review, adjustment, and application of pricing methodologies to medical claims. This role ensures claims are priced in accordance with provider contracts, fee schedules, and benefit structures. The position plays a critical role in maintaining pricing integrity, minimizing rework, and supporting operational efficiency in a high-volume claims environment.
Key Responsibilities
- Review and reprice medical claims to ensure accurate application of provider contracts, fee schedules, and reimbursement methodologies
- Analyze pricing discrepancies and perform adjustments to align with contractual and system guidelines
- Research complex claims scenarios, including escalations from Provider Services and Claims Processing
- Partner with Configuration, Network Management, and Claims teams to resolve pricing issues and system defects
- Validate contract terms and ensure proper interpretation within claims adjudication systems
- Maintain productivity, quality, and turnaround time standards in a high-volume environment
- Document findings and maintain audit-ready records of adjustments and issue resolution
- Identify pricing trends, root causes, and recommend process improvements to reduce errors and rework
Required Qualifications
- High school diploma or equivalent required; Associate's or Bachelor's degree preferred
- 2-4 years of experience in healthcare claims processing, pricing, or repricing
- Strong knowledge of claims adjudication and reimbursement methodologies (e.g., fee schedules, contract pricing)
- Experience interpreting provider contracts and pricing logic preferred
- Strong analytical and problem-solving skills with attention to detail
- Ability to manage fluctuating workloads and prioritize effectively
- Proficiency in Microsoft Office (Excel, Word) and claims systems
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
What Independence Blue Cross employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Independence Blue Cross
Sourced by ZipRecruiter
Industry
Insurance services
Company size
1,001 - 5,000 Employees
Headquarters location
Philadelphia, PA, US
Year founded
1938