ZipRecruiter

Log In

1

Health Insurance Claims Examiner Jobs (NOW HIRING)

Independent Living Systems

Claims Examiner

Miami, FL · On-site

By maintaining up-to-date knowledge of healthcare regulations and insurance policies, the Claims Examiner helps protect the organization from financial loss and supports the delivery of fair and ...

Independent Living Systems

Claims Examiner

Miami, FL · On-site

By maintaining up-to-date knowledge of healthcare regulations and insurance policies, the Claims Examiner helps protect the organization from financial loss and supports the delivery of fair and ...

Southern Mutual Church Insurance

Be Seen First

Claims Examiner

Columbia, SC · On-site

Southern Mutual Church Insurance Company located in Columbia, SC is a leading provider of property ... The Claims Examiner is responsible for reviewing, evaluating, and resolving insurance claims in ...

Capital Health Plan

Claims Examiner I

Tallahassee, FL · On-site

Capital Health Plan is looking for a full-time Claims Examiner I to join our team in Tallahassee, FL. In this full-time role, you will help ensure insurance claims are reviewed, evaluated, and ...

Capital Health Plan

Claims Examiner I

Tallahassee, FL · On-site

Capital Health Plan is looking for a full-time Claims Examiner I to join our team in Tallahassee, FL. In this full-time role, you will help ensure insurance claims are reviewed, evaluated, and ...

Capital Health Plan

Claims Examiner I

Tallahassee, FL · On-site

Capital Health Plan is looking for a full-time Claims Examiner I to join our team in Tallahassee, FL. In this full-time role, you will help ensure insurance claims are reviewed, evaluated, and ...

Trident

Medical Claims Examiner

$30/hr

We are seeking a highly skilled and independent Claims Examiner to join our team on a 100% remote ... Demonstrated background processing self-funded medical health insurance claims. * Contractor ...

Wellcove

Claims - Claims Examiner

Pensacola, FL · On-site

... health insurance programs. Our team provides individuals and their families with peace of mind ... The Long-Term Care (LTC) Claims Examiner is responsible for the accurate and timely adjudication of ...

University Health

Claims Examiner

San Antonio, TX

We are looking for an experienced Claims Examiner for our Claims department with Community First ... and CHIP (Children's Health Insurance Program) according to departmental and regulatory ...

Next Step Systems

Claims Examiner

Tucson, AZ · On-site

Benefits include medical insurance, retirement plan, PTO, etc. Salary: 80K+ DOE. Keywords: Tucson AZ Jobs, Claims Examiner, ICD-10, CPT, Healthcare Common Procedure Coding System, HCPCS, In-Patient ...

next page

Showing results 1-20

All JobsFinance And Insurance JobsInsurance JobsInsurance Claims Examiner JobsHealth Insurance Claims Examiner Jobs

Health Insurance Claims Examiner information

See salary details

$40K

$61.6K

$92K

How much do health insurance claims examiner jobs pay per year?

As of Sep 10, 2026, the average yearly pay for health insurance claims examiner in the United States is $61,600.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,000.00 and $65,500.00 per year, depending on experience, location, and employer.
More about Health Insurance Claims Examiner jobs

What are popular job titles related to Health Insurance Claims Examiner jobs?

For Health Insurance Claims Examiner jobs, the most frequently searched job titles are:

Health Insurance Claims Examiner jobs near you
Infographic showing various Health Insurance Claims Examiner job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $61,600 per year, or $29.6 per hour.

Claims Examiner

Miami, FL • On-site

Independent Living Systems
Health Care and Social Assistance • 501 - 1,000 employees
Learn more about Independent Living Systemsexternal

Full-time

Posted 12 days ago

Independent Living Systems rating

6.5

Company rating: 6.5 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

We are seeking a Claims Examiner to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Claims Examiner plays an essential role by thoroughly reviewing and evaluating insurance claims to ensure accuracy, compliance, and appropriateness of payments. This position involves analyzing medical documentation, policy details, and billing information to determine the validity of claims and identify any discrepancies or potential fraud. The Claims Examiner collaborates with healthcare providers, and internal teams to resolve claim issues and facilitate timely reimbursement. By maintaining up-to-date knowledge of healthcare regulations and insurance policies, the Claims Examiner helps protect the organization from financial loss and supports the delivery of fair and efficient claims processing. Ultimately, this role contributes to the integrity and sustainability of the organization by ensuring claims are processed accurately and ethically.

Minimum Qualifications:

  • High school diploma or GED.
  • Minimum of 2 years experience in claims examination, medical billing, or healthcare insurance processing.
  • Strong understanding of medical terminology, insurance policies, and healthcare billing codes (e.g., ICD-10, CPT).
  • Proficiency with claims management software and Microsoft Office suite.

Preferred Qualifications:

  • Associate’s degree or Bachelor's degree in health administration, healthcare management, or a related discipline.
  • Certification such as Certified Professional Coder (CPC) or Certified Claims Professional (CCP).
  • Experience working within the health care and social assistance industry or with government healthcare programs.
  • Familiarity with regulatory frameworks such as HIPAA and the Affordable Care Act.

Responsibilities:

  • Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
  • Review and analyze health insurance claims for completeness, accuracy, and compliance with policy terms and regulatory requirements.
  • Verify medical codes, treatment documentation, and billing information to ensure services are properly covered and billed.
  • Investigate and resolve claim discrepancies by communicating with providers and internal stakeholders.
  • Identify and escalate potential fraudulent claims or billing errors to compliance or legal teams.
  • Maintain detailed records of claim evaluations and stay current with healthcare laws and industry standards to support audits and improve processing workflows.
  • Perform other duties as assigned.



What Independent Living Systems employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom