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Contractual Adjudication Jobs (NOW HIRING)

Parkland Health

... 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 ...

Clover Health

Director, Claim Payment Accuracy

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 ...

ImageNetLLC

Claims Examiner - Remote

Tampa, FL · Remote

... guidelines, contractual agreements, regulatory requirements, and internal policies ... Understanding of health claims processing/adjudication * Ability to perform basic to intermediate ...

MetroPlusHealth

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

MetroPlusHealth

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

ImagenetLLC

Claims Examiner - Remote

Tampa, FL · Remote

... guidelines, contractual agreements, regulatory requirements, and internal policies ... Understanding of health claims processing/adjudication * Ability to perform basic to intermediate ...

Imagenet

Claims Examiner - Remote

Tampa, FL · Remote

... guidelines, contractual agreements, regulatory requirements, and internal policies ... Understanding of health claims processing/adjudication * Ability to perform basic to intermediate ...

Assurant, Inc

Sr. Auto Claims Analyst

San Juan, PR · On-site

Offshore Adjudication Oversight & Quality Enablement * Provide indirect oversight and technical ... Assess adherence to contractual requirements, repair practices, quality standards, and cost ...

Imagenet

Claims Examiner - Remote (Alameda)

Tampa, FL · Remote

... guidelines, contractual agreements, regulatory requirements, and internal policies ... Understanding of health claims processing/adjudication * Ability to perform basic to intermediate ...

New

Imagenet

Claims Examiner - Remote

Tampa, FL · On-site +1

... guidelines, contractual agreements, regulatory requirements, and internal policies ... Understanding of health claims processing/adjudication * Ability to perform basic to intermediate ...

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Showing results 21-40

All JobsContractual Adjudication Jobs

Contractual Adjudication information

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$8

$38

$70

How much do contractual adjudication jobs pay per hour?

As of Aug 6, 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?

AspectContractual AdjudicationContract Administrator
CredentialsLegal or contractual training, certifications in dispute resolutionProject management, contract management certifications
Work EnvironmentLegal, dispute resolution, or contractual review settingsConstruction, engineering, or project management offices
Industry UsageLegal and dispute resolution sectorsConstruction, 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.

What qualifications do I need to be a contractual adjudicator?

To become a contractual adjudicator, candidates typically need a background in law, construction, or engineering, along with strong analytical and communication skills. Relevant experience in contract management or dispute resolution is often required, and some roles may require certification in adjudication or dispute resolution methods. Familiarity with industry-specific regulations and the ability to work under tight deadlines are also important.

Do you need a degree to be a contractual adjudicator?

A contractual adjudicator typically does not require a specific degree, but relevant education such as a law degree or certification in dispute resolution can be beneficial. Strong analytical skills, knowledge of contract law, and experience with legal or contractual processes are often important for the role.
More about Contractual Adjudication jobs
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What are the most commonly searched types of Adjudication jobs? The most popular types of Adjudication jobs are:
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What job categories do people searching Contractual Adjudication jobs look for? The top searched job categories for Contractual Adjudication jobs are:
Contractual Adjudication jobs near you
Infographic showing various Contractual Adjudication job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 10% Part Time, and 2% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution, with an average salary of $79,243 per year, or $38.1 per hour.

Claims Repricer

Independence Blue Cross

Philadelphia, PA • On-site

Full-time

Re-posted 27 days ago

Independence Blue Cross rating

8.6

Company rating: 8.6 out of 10

Based on 25 frontline employees who took The Breakroom Quiz

88th of 301 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
  • 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.

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