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Flexible Claim Reviewer Jobs (NOW HIRING)

Gainwell Technologies

$78 - $85/hr

Actively cross‑train to perform reviews of multiple claim types to support a flexible workforce that meets client needs. What we're looking for * Active, unrestricted RN license in the United ...

Chubb

AVP, Claim - Worker's Comp

Philadelphia, PA · On-site

Actively participate in claim committees, account file reviews, and project teams to address ... Ability to be flexible, imaginative, and to work well in teams. * Exceptional organizational ...

Arbella 56 Group

Claim Manager - Analytics

Quincy, MA · On-site

$145 - $165/hr

That means providing a great work environment, encouraging work/life balance, offering flexible ... Assign projects to the team after reviewing business requests and needs that emerge from business ...

Addison Group

Forensic Medical Coder

Niagara Falls, NY · Remote

$25 - $30/hr

This position supports insurance-related claim reviews through detailed analysis of medical records ... Flexible scheduling following completion of training. * Long-term contract opportunity with ongoing ...

Machinify

Claims Administrator

$24/hr

This role involves performing incoming claim reviews, organizing data, assigning statuses, and ... flexible spending accounts * Tuition Reimbursement * Eligibility for company-paid benefits ...

Dahl Consulting

Claims Administrator

Saint Paul, MN · Hybrid

$22 - $25/hr

Coordinate claim activities throughout the claim lifecycle, from notification to resolution ... Once weve reviewed your application details, a recruiter will reach out to you with next steps!

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Flexible Claim Reviewer information

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How much do flexible claim reviewer jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for flexible claim reviewer in the United States is $21.05, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $22.84 per hour, depending on experience, location, and employer.

What is the difference between Flexible Claim Reviewer vs Insurance Claims Processor?

AspectFlexible Claim ReviewerInsurance Claims Processor
Required CredentialsHigh school diploma or equivalent; some roles may prefer certifications in claims or insuranceHigh school diploma or equivalent; often requires familiarity with claims processing software
Work EnvironmentOffice setting, often remote or hybrid; involves reviewing claims and documentationOffice environment; processes insurance claims, verifies information, and inputs data
Employer & Industry UsageInsurance companies, third-party administrators, healthcare providersInsurance companies, healthcare providers, government agencies

Flexible Claim Reviewers focus on evaluating claims for accuracy and compliance, often with more flexibility in tasks. Insurance Claims Processors handle the processing and data entry of claims, typically following standardized procedures. Both roles require knowledge of insurance policies and claims procedures, but their daily tasks and responsibilities differ slightly.

What cities are hiring for Flexible Claim Reviewer jobs?

Cities with the most Flexible Claim Reviewer job openings:

What are the most commonly searched types of Claim Reviewer jobs?

The most popular types of Claim Reviewer jobs are:

What states have the most Flexible Claim Reviewer jobs?

States with the most job openings for Flexible Claim Reviewer jobs include:

Flexible Claim Reviewer jobs near you

Nurse Reviewer - Itemized Bill Review

Gainwell Technologies

On-site

$78 - $85/hr

Other

Medical, Life, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

Gainwell Technologies rating

7.9

Company rating: 7.9 out of 10

Based on 84 frontline employees who took The Breakroom Quiz

130th of 247 rated software companies

Job description

Location: Any city, TX, US, 99999

Work Mode: Virtual (Exception only)

Summary

We are seeking a talented individual for a Nurse Reviewer - Itemized Bill Review role to perform reviews of medical records, healthcare claims, itemized medical bills, and UB‑04 forms to ensure accuracy, compliance, and proper billing practices. This position requires clinical review expertise as well as experience with itemized bill review.

Your role in our mission
  • Review medical claims using the UB‑04 and detailed itemized statements to validate line‑item charges.
  • Verify accuracy of itemized charges in accordance with client policy and industry standards.
  • Perform level‑of‑care and utilization reviews by analyzing medical records and comparing them against criteria to determine appropriateness and reasonableness of care.
  • Apply critical thinking and decision‑making skills to determine whether medical record documentation supports the need for services while meeting production goals and quality standards.
  • Assist management with training new reviewers, including daily monitoring, mentoring, feedback, and education.
  • Maintain current knowledge of clinical criteria guidelines and/or coding guidelines; complete required CEUs to maintain RN licensure.
  • Attend training and scheduled meetings to enhance knowledge of clinical policies, procedures, rules, and regulations.
  • Actively cross‑train to perform reviews of multiple claim types to support a flexible workforce that meets client needs.
What we're looking for
  • Active, unrestricted RN license in the United States and in the primary state of residence; active compact multistate RN license as defined by the Nurse Licensure Compact (NLC) required.
  • 5+ years of clinical experience in an inpatient hospital setting required.
  • 1+ year of itemized bill review experience required.
  • 3+ years of utilization review or claims auditing experience preferred.
  • Experience with CPT, ICD‑10, and HCPCS coding guidelines.
  • Experience using MCG or InterQual criteria preferred.
  • Ability to multitask in a fast‑paced production environment.
What you should expect in this role
  • This is a home‑based position, and you must have a work location within the continental United States.
  • You must provide a high‑speed internet connection and maintain a work environment free from distractions.
  • Ability to work during normal business hours, as this role requires frequent interaction with the team and other departments.
  • May be required to work extended hours for special business needs.
  • May be required to travel at least 10% of the time based on business needs.

This position is for pipeline purposes, and we welcome applications on an ongoing basis.

The pay range for this position is $78,000.00 - $85,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job‑related knowledge, skills, and experience among other factors. All salaried, full‑time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

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What Gainwell Technologies employees say

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Hours and flexibility

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About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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