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Health Insurance Adjuster Jobs (NOW HIRING)

Coordinating with insurance adjusters by attending adjuster meetings to discuss the scope of damage ... Health, dental, and vision insurance options * 401(k) retirement plan with company match

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Health Insurance Adjuster information

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$19.5K

$74.7K

$110.5K

How much do health insurance adjuster jobs pay per year?

As of Jul 21, 2026, the average yearly pay for health insurance adjuster in the United States is $74,680.00, according to ZipRecruiter salary data. Most workers in this role earn between $48,000.00 and $100,000.00 per year, depending on experience, location, and employer.

How do I become a medical claims adjuster?

To become a health insurance claims adjuster, you typically need a high school diploma or equivalent, and some states require a license which involves completing pre-licensing courses and passing an exam. Relevant skills include attention to detail, knowledge of insurance policies, and proficiency with claims processing software. Gaining experience through entry-level positions or internships can also be beneficial.

What are the key skills and qualifications needed to thrive as a Health Insurance Adjuster, and why are they important?

To thrive as a Health Insurance Adjuster, you need a strong understanding of insurance policies, claims processing, and relevant legal regulations, often supported by a bachelor's degree or industry-specific certifications. Familiarity with claims management software, medical billing systems, and regulatory databases is typically required. Attention to detail, negotiation skills, and effective communication are essential soft skills for evaluating claims and interacting with policyholders. These skills ensure accurate claims assessment, compliance with industry standards, and positive client relations, all of which are crucial for success in this role.

Is it worth becoming a claims adjuster?

A health insurance claims adjuster evaluates insurance claims related to health coverage, requiring strong attention to detail and knowledge of insurance policies. The role offers steady employment, typically with a 40-hour workweek, and may require certification or training. Career growth depends on experience and specialization, making it a viable option for those interested in insurance and healthcare industries.

What does a Health Insurance Adjuster do?

A Health Insurance Adjuster is responsible for evaluating health insurance claims to determine the extent of the insurance company's liability. They review medical records, verify policy coverage, and communicate with healthcare providers, policyholders, and sometimes legal professionals. Their goal is to ensure claims are processed accurately and fairly, approving legitimate claims and identifying potential fraud or errors. Adjusters play a crucial role in helping policyholders receive the benefits they are entitled to while protecting the financial interests of the insurance company.

Is claim adjusting a dying field?

Claim adjusting is a stable profession within the insurance industry, with ongoing demand for skilled adjusters to evaluate and process claims. Technological advancements like claims management software and automation have changed some processes but have not eliminated the need for human adjusters, especially those with certifications and strong analytical skills.

What kind of insurance adjuster makes the most money?

In the insurance adjusting field, catastrophe or claims managers typically earn the highest salaries due to their responsibility for large-scale claims and disaster response. These roles often require extensive experience, specialized certifications, and the ability to handle complex, high-value claims, which contribute to higher compensation compared to standard property or casualty adjusters.

What are some typical challenges a Health Insurance Adjuster faces when investigating claims?

Health Insurance Adjusters often encounter challenges such as interpreting complex policy language, verifying the legitimacy of medical claims, and balancing the needs of the claimant with company policies. They must evaluate detailed medical records, communicate with healthcare providers, and ensure compliance with ever-changing regulations. Navigating these complexities requires strong analytical skills, attention to detail, and effective communication to resolve claims fairly and efficiently.
More about Health Insurance Adjuster jobs
What cities are hiring for Health Insurance Adjuster jobs? Cities with the most Health Insurance Adjuster job openings:
What states have the most Health Insurance Adjuster jobs? States with the most job openings for Health Insurance Adjuster jobs include:
Infographic showing various Health Insurance Adjuster job openings in the United States as of July 2026, with employment types broken down into 17% Locum Tenens, 21% Internship, 56% Full Time, 1% Part Time, 2% Contract, and 3% Summer. Highlights an 81% Physical, 6% Hybrid, and 13% Remote job distribution, with an average salary of $74,680 per year, or $35.9 per hour.
Homeowner Liability Lead Litigation Desk Adjuster (Primarily Home)

Homeowner Liability Lead Litigation Desk Adjuster (Primarily Home)

American Family Mutual Insurance Company Si

Phoenix, AZ

$88K - $145K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 4 days ago


American Family Insurance rating

7.5

Company rating: 7.5 out of 10

Based on 135 frontline employees who took The Breakroom Quiz

202nd of 281 rated insurance


Job description

You'll investigate and maintain highly complex property/casualty claims. Determines liability, secures information, reviews coverages, arranges appraisals, and settles claims. Demonstrates experience to perform all areas of claim adjustment activities with the highest degree of competency and independence. May specialize in liability, property or catastrophe claims.

Position Compensation Range:

$88,000.00 - $145,000.00

Pay Rate Type:

Salary

Compensation may vary based on the job level and your geographic work location. Relocation support is offered for eligible candidates.

Primary Accountabilities

  • Investigates origin and cause of high exposure claims by contacting the appropriate parties including insureds, claimants, agents, attorneys, contractors, experts, special investigation unit, other adjusters, public personnel, etc. Checks for prior claims and recognizes environmental exposures.

  • Participates in High Damage Reviews (HDR) to address coverage issues and exposure. Handles claims on a good faith basis.

  • Handles both 3rd party claims under multiple policy types and numerous endorsements.

  • Conducts on-site inspections when needed, evaluates damages and handles claim negotiations with insureds, claimants, attorneys, public adjusters.

  • Responds to customer inquiries, makes appropriate decisions, and closes file as needed.

  • Interprets and determines policies, leases, by-laws, declarations, articles, and contract coverages and applies to all parties for assigned losses. Interprets claim history coverages.

  • Makes independent decisions but recognizes when assistance is needed.

  • Proactively provides all parties with claim process and status as appropriate; answers questions or redirects to other areas.

  • Serves as a mentor and subject matter expert for less experienced adjusters.

  • May be required to complete other assignments, job duties, or participate in projects based upon skills, achievements, or experience.


Specialized Knowledge & Skills Requirements

  • Demonstrated ability to handle 3rd party, multi-line claims across our operating territories.

  • Demonstrated experience providing customer-driven solutions, support or service.

  • Demonstrated ability to efficiently and effectively handle complex claims.

  • Extensive knowledge of policies and endorsements coverages.

  • Successfully applied knowledge of each phase of the claim handling process.

  • Litigation experience preferred but not required.


Licenses

  • Obtain state specific property casualty claims licensing as required.


Travel Requirements

  • Up to 10%.

  • Catastrophe travel up to 75% as applicable.


Physical Requirements

  • Work that primarily involves sitting/standing.

Additional Information
  • To ensure a strong start, all employees participate in our New Employee Orientation during their first week. This experience is held in person at our Madison, WI Headquarters or one of our AmFam core locations to help you connect with our mission, meet key team members and build relationships that support your growth. At times, sessions may be delivered virtually based on scheduling and availability.
  • Offer to selected candidate will be made contingent on the results of applicable background checks
  • Offer to selected candidate is contingent on signing a non-disclosure agreement for proprietary information, trade secrets, and inventions
  • Sponsorship will not be considered for this position unless specified in the posting

We provide benefits that support your physical, emotional, and financial wellbeing. You will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health. We also offer a competitive 401(k) contribution, a pension plan, an annual incentive, 9 paid holidays and a paid time off program (23 days accrued annually for full-time employees). In addition, our student loan repayment program and paid-family leave are available to support our employees and their families. Interns and contingent workers are not eligible for American Family Insurance Group benefits.

We are an equal opportunity employer. It is our policy to comply with all applicable federal, state and local laws pertaining to non-discrimination, non-harassment and equal opportunity. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law.

American Family Insurance is committed to the full inclusion of all qualified individuals. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please email AskHR@AmFam.com to request a reasonable accommodation.

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