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Health Insurance Claims Job Jobs (NOW HIRING)

Professional Transit

Claims Coordinator

Tucson, AZ · On-site

$17.60 - $26.40/hr

Sun Tran is seeking a detail-oriented Part-Time (24 hours per week) Claims Coordinator to support ... BENEFITS Comprehensive benefits package including health insurance for employees and dependents ...

Trustmark

Life Insurance Claims Consultant

$62K - $90K/yr

About the role Responsible for reviewing and processing claims including, identifying ... Health/dental/vision, life insurance, FSA and HSA, 401(k) plan, Employee Assistant Program, Back-up ...

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 ...

UHA

Claims Services Manager

Honolulu, HI · On-site

$90K - $118K/yr

JOIN UHA'S TEAM We focus on your health and pay 100% for your family's medical insurance and provide 20 days of paid personal time off during your first year! Department: Claims Services FLSA ...

American Express

Insurance Claims Adjuster

Phoenix, AZ · On-site

This means caring for you and your loved ones' physical, financial, and mental health, as well as ... Travel and Medical Claims experience * Insurance, Medical or Travel Industry experience Employment ...

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Health Insurance Claims Job information

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How much do health insurance claims job jobs pay per hour?

As of Jul 7, 2026, the average hourly pay for health insurance claims job in the United States is $23.50, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $25.72 per hour, depending on experience, location, and employer.
Insurance Claims Examiner II

Insurance Claims Examiner II

Forest County Potawatomi

WI • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 15 days ago

Job description

Here's what you'll be doing:
Level II
Level III
1
Analyzes and processes minimum of 200 claims daily to determine plan liability; reviews payment Purchased Referred Care, medical, dental and vision claims
Analyzes and processes minimum of 400 claims to determine plan liability; reviews payment Purchased Referred Care, medical, dental and vision claims
2
Compiles, submits documents, and tracks claims for CHEF, (Catastrophic Health Emergency Fund), for reimbursement, to Bemidji Area Contract Health for high-cost cases, following current IHS guidelines and regulations
Compiles, submits documents, and tracks claims for CHEF, (Catastrophic Health Emergency Fund), for reimbursement, to Bemidji Area Contract Health for high-cost cases, following current IHS guidelines and regulations
3
Collaborates with the Eligibility team to ensure payer of last resort stance is utilized when handling Purchased Referred Care claims and payments
Collaborates with the Eligibility team to ensure payer of last resort stance is utilized when handling Purchased Referred Care claims and payments
4
Assists with other research and development projects as directed by Management; obtains and maintains necessary certification for Health Insurance Marketplace CAC
Provides training and guidance through expert knowledge of claims administration and adjudication to Insurance Department staff; responsible for the timely response to formal appeals from members, employees, clients and providers
5
Reviews, resolves and/or escalates Level 2 claims appeals; releases claims up to the designated draft authority for Level 2 Claims Examiner
Works with the Customer Service Coordinator to manage and provide direction to the utilization review and case management vendor; identifies and manages claims with potential subrogated recovery
6
Ensures that claims adjudication complies with all FCPID standards and protocols; reviews claims for possible abuses and/or fraud and bring to the attention of management
Oversees the repricing processes to ensure the integrity of the product; investigates claims referred by staff for possible abuse and fraud
What you'll need to be successful:
Level II
Level III
1
High School Diploma or GED
High School Diploma or GED
2
Five (5) years of experience in medical claims processing
Five (5) years of experience in medical claims processing
3
Three (3) years in customer service
Three (3) years in customer service
4
Knowledge of Indian Health Service guidelines as it pertains to payment of medical providers and health benefits claims processing standards
Two (2) years in a lead or supervisory capacity
5
Knowledge of NCCI and CMS coding/billing standards, CPT-4, ICD-9, ICD-10, DRG and HCPS and medical terminology
Knowledge of Indian Health Service guidelines as it pertains to payment of medical providers and health benefits claims processing standards
6
Knowledge of insurance principles and/or procedures
Knowledge of NCCI and CMS coding/billing standards, CPT-4, ICD-9, ICD-10, DRG and HCPS and medical terminology
7
Skill in operating various word-processing, spreadsheets, and database software programs in a Windows environment
Knowledge of insurance principles and/or procedures
8
Must successfully pass all applicable background checks and drug screens
Skill in operating various word-processing, spreadsheets, and database software programs in a Windows environment
9
Must successfully pass all applicable background checks and drug screens
Benefits you'll love:
  • Approximately 5 weeks of paid time off annually
  • 3 weeks of paid holidays
  • Premium free health insurance
  • Flexible spending accounts
  • Short term disability
  • Life insurance
  • 401k with match

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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