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Healthcare Claims Management Jobs (NOW HIRING)

Wellcove

Claims - Claims Examiner

Pensacola, FL · On-site

Knowledge of medical terminology and healthcare documentation * Proficiency in claims systems and ... Ability to manage multiple priorities in a fast-paced environment Core Competencies * Attention to ...

Walmart

Case Manager I, Claims Management

Johnson, AR · On-site

$60K - $110K/yr

Health benefits include medical, vision and dental coverage. Financial benefits include 401(k) ... Paid time off benefits include PTO (including sick leave), parental leave, family care leave ...

Walmart

Case Manager I, Claims Management

Pea Ridge, AR · On-site

$60K - $110K/yr

Health benefits include medical, vision and dental coverage. Financial benefits include 401(k) ... Paid time off benefits include PTO (including sick leave), parental leave, family care leave ...

Walmart

Case Manager I, Claims Management

Bella Vista, AR · On-site

$60K - $110K/yr

Health benefits include medical, vision and dental coverage. Financial benefits include 401(k) ... Paid time off benefits include PTO (including sick leave), parental leave, family care leave ...

Walmart

Case Manager I, Claims Management

Bentonville, AR · On-site

$60K - $110K/yr

Health benefits include medical, vision and dental coverage. Financial benefits include 401(k) ... Paid time off benefits include PTO (including sick leave), parental leave, family care leave ...

Walmart

Case Manager I, Claims Management

Elkins, AR · On-site

$60K - $110K/yr

Health benefits include medical, vision and dental coverage. Financial benefits include 401(k) ... Paid time off benefits include PTO (including sick leave), parental leave, family care leave ...

Walmart

Case Manager II, Claims Management

Cassville, MO · On-site

$70K - $130K/yr

Health benefits include medical, vision and dental coverage. Financial benefits include 401(k) ... Paid time off benefits include PTO (including sick leave), parental leave, family care leave ...

Walmart

Case Manager II, Claims Management

Pea Ridge, AR · On-site

$70K - $130K/yr

Health benefits include medical, vision and dental coverage. Financial benefits include 401(k) ... Paid time off benefits include PTO (including sick leave), parental leave, family care leave ...

Walmart

Case Manager II, Claims Management

Rogers, AR · On-site

$70K - $130K/yr

Health benefits include medical, vision and dental coverage. Financial benefits include 401(k) ... Paid time off benefits include PTO (including sick leave), parental leave, family care leave ...

Walmart

Case Manager II, Claims Management

Farmington, AR · On-site

$70K - $130K/yr

Health benefits include medical, vision and dental coverage. Financial benefits include 401(k) ... Paid time off benefits include PTO (including sick leave), parental leave, family care leave ...

Walmart

Case Manager II, Claims Management

Anderson, MO · On-site

$70K - $130K/yr

Health benefits include medical, vision and dental coverage. Financial benefits include 401(k) ... Paid time off benefits include PTO (including sick leave), parental leave, family care leave ...

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Healthcare Claims Management information

See salary details

$35K

$87.9K

$139K

How much do healthcare claims management jobs pay per year?

As of Aug 17, 2026, the average yearly pay for healthcare claims management in the United States is $87,861.00, according to ZipRecruiter salary data. Most workers in this role earn between $68,000.00 and $105,000.00 per year, depending on experience, location, and employer.

What is healthcare claims management?

Healthcare claims management is the process of handling medical insurance claims, from submission to reimbursement. It involves reviewing, processing, and following up on claims sent to insurance companies by healthcare providers. The goal is to ensure that providers are accurately paid for services rendered and that patients' insurance benefits are correctly applied. Effective claims management helps reduce denials, improve cash flow, and minimize administrative errors in healthcare billing.

What are the key skills and qualifications needed to thrive in healthcare claims management?

To thrive in Healthcare Claims Management, you need a solid understanding of medical billing, insurance policies, coding systems (such as ICD-10 and CPT), and typically a relevant associate’s or bachelor’s degree. Familiarity with claims processing software, electronic health record (EHR) systems, and regulatory compliance tools is essential. Strong attention to detail, analytical thinking, and effective communication help you resolve discrepancies and interact with providers and payers. These skills are crucial for ensuring accurate claims processing, minimizing denials, and maintaining efficient revenue cycles in healthcare organizations.

What are some common challenges faced in healthcare claims management, and how can professionals effectively address them?

Healthcare claims management professionals often encounter challenges such as processing complex claims, navigating frequent regulatory changes, and handling denied or delayed claims. To address these issues, professionals must stay updated on the latest healthcare regulations and payer requirements and develop strong attention to detail when reviewing documentation. Collaborating closely with billing teams and insurance providers, as well as using advanced claims management software, can help streamline workflows and reduce errors, ultimately improving the accuracy and efficiency of claims processing.

What is the difference between Healthcare Claims Management vs Medical Billing Specialist?

AspectHealthcare Claims ManagementMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies, coding, and claims processing; certifications like CPC or CCS are commonRequires coding and billing knowledge; certifications like CPC are often preferred
Work EnvironmentOften in healthcare offices, insurance companies, or claims processing centersPrimarily in medical offices, hospitals, or billing companies
Job FocusManaging and processing insurance claims, resolving claim denials, ensuring compliancePreparing and submitting patient bills, coding procedures, and following up on payments
Industry UsageUsed across healthcare providers, insurance companies, and third-party administratorsPrimarily used within healthcare providers' billing departments

While both roles involve billing and coding, Healthcare Claims Management focuses on overseeing the entire claims process, including denials and compliance, whereas Medical Billing Specialists handle the day-to-day billing and coding tasks for patient accounts.

Is healthcare claims management a stressful job?

Healthcare claims management can be stressful due to the need for accuracy, meeting deadlines, and handling complex insurance policies. The role often requires attention to detail, strong organizational skills, and the ability to manage high workloads, especially during busy periods or audits.
More about Healthcare Claims Management jobs

What cities are hiring for Healthcare Claims Management jobs?

Cities with the most Healthcare Claims Management job openings:

What states have the most Healthcare Claims Management jobs?

States with the most job openings for Healthcare Claims Management jobs include:

What job categories do people searching Healthcare Claims Management jobs look for?

The top searched job categories for Healthcare Claims Management jobs are:

Healthcare Claims Management jobs near you
Infographic showing various Healthcare Claims Management job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $87,861 per year, or $42.2 per hour.

Claims - Claims Examiner

Wellcove

Pensacola, FL • On-site

Full-time

Re-posted 16 days ago

Job description

Who We Are
Wellcove has been recognized as the nation's leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don't stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs.
Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology.
The Long-Term Care (LTC) Claims Examiner is responsible for the accurate and timely adjudication of long-term care insurance claims. This role ensures compliance with policy provisions, regulatory requirements, and company standards while delivering a high level of customer service to policyholders, providers, and internal stakeholders.
  • Review, evaluate, and adjudicate Long Term Care claims in accordance with policy provisions and established guidelines
  • Analyze claim documentation including invoices, care plans, and provider credentials
  • Apply knowledge of Coordination of Benefits (COB), Medicare, Medicaid, and other payer sources when applicable
  • Ensure claims are processed within established turnaround times and service level agreements (SLAs)
  • Communicate effectively with policyholders, providers, and internal teams regarding claim status, requirements, and determinations
  • Identify and request additional documentation when necessary to support claim decisions
  • Maintain accurate and detailed claim notes in system of record
  • Ensure compliance with HIPAA and all applicable regulatory and privacy requirements
  • Participate in quality assurance activities and implement feedback for continuous improvement
  • Support training and mentoring of new or junior staff as needed
  • Required Qualifications
    • High school diploma or equivalent required; associate or bachelor's degree preferred
    • 2+ years of experience in insurance claims, healthcare administration, or Long-Term Care claims processing
    • Strong understanding of Long-Term Care policies, benefits, and eligibility criteria preferred
    • Knowledge of medical terminology and healthcare documentation
    • Proficiency in claims systems and Microsoft Office (Excel, Word, Outlook)
    • Strong analytical and decision-making skills
    • Excellent written and verbal communication skills
    • Ability to manage multiple priorities in a fast-paced environment

    Core Competencies
    • Attention to Detail
    • Critical Thinking & Problem Solving
    • Customer Focus
    • Time Management & Productivity
    • Compliance & Risk Awareness
    • Team Collaboration

At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

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