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Insurance Claim Review Jobs (NOW HIRING)

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, billing documentation, and coding practices. The ideal candidate enjoys investigative work, has ...

UMR

SSBV Clinical Claim Review | , |

$28.94 - $51.83/hr

Ssbv Clinical Claims Review Rn Optum is a global organization that delivers care, aided by ... Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability ...

divvyDOSE

SSBV Clinical Claim Review | , |

$28.94 - $51.83/hr

Ssbv Clinical Claims Review Rn Optum is a global organization that delivers care, aided by ... Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability ...

Church Mutual Insurance

Claim Processor

Merrill, WI · On-site

$18.50 - $23.25/hr

Verify coverage and determine our obligation(s) to the insured and/or claimant. * Review claims to determine type of claim presented, claim documentation/evidence presented, amount of claim, or ...

Church Mutual Insurance, S.I.

Claim Processor

Milwaukee, WI · On-site

$16.75 - $21.25/hr

Verify coverage and determine our obligation(s) to the insured and/or claimant. * Review claims to determine type of claim presented, claim documentation/evidence presented, amount of claim, or ...

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Insurance Claim Review information

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How much do insurance claim review jobs pay per hour?

As of Sep 15, 2026, the average hourly pay for insurance claim review 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.

What is insurance claim review?

Insurance claim review is the process by which insurance companies evaluate claims submitted by policyholders to determine their validity and the extent of coverage. Claims reviewers carefully examine documentation, such as medical records, police reports, or repair estimates, to ensure all policy requirements are met. This process helps prevent fraud, ensures claims are paid accurately, and maintains the integrity of the insurance system. Claim reviewers may also communicate with claimants, request additional information, or work with other professionals to make informed decisions.

What are the key skills and qualifications needed to thrive as an insurance claim review specialist?

To thrive as an Insurance Claim Review Specialist, you typically need a strong understanding of insurance policies, claims processes, and relevant regulations, often backed by a degree in business, finance, or a related field. Familiarity with claims management software, document management systems, and sometimes certifications such as AIC (Associate in Claims) are commonly required. Attention to detail, analytical thinking, and effective communication are critical soft skills for evaluating claims and interacting with policyholders. These skills ensure accurate, timely, and fair claim resolutions that uphold company standards and customer satisfaction.

What are some common challenges faced in an insurance claim review role, and how can they be managed effectively?

One of the most common challenges in Insurance Claim Review is managing a high volume of claims while maintaining accuracy and compliance with regulatory standards. Claims can often be complex, requiring careful analysis of policy terms, medical or incident documentation, and communications with policyholders or third parties. Effective time management, attention to detail, and strong communication skills are essential. Collaborating closely with other departments, such as underwriting and legal, can also help resolve ambiguous cases more efficiently. Ongoing training and keeping up with changes in industry regulations further support success in this role.

What is the difference between Insurance Claim Review vs Insurance Adjuster?

AspectInsurance Claim ReviewInsurance Adjuster
CredentialsTypically requires insurance or claims processing certificationsRequires licensing and adjuster certifications
Work EnvironmentOffice-based, reviewing claims remotely or on-siteFieldwork, inspecting damages, meeting clients
Employer & Industry UsageInsurance companies, third-party claims servicesInsurance companies, independent adjusting firms
Search & Comparison IntentUnderstanding claim review roles, job dutiesAssessing damage, settling claims

Insurance Claim Review professionals focus on evaluating and verifying insurance claims, often working in an office setting. Insurance Adjusters, on the other hand, inspect damages firsthand and negotiate settlements. Both roles require insurance-related certifications but differ in work environment and responsibilities.

More about Insurance Claim Review jobs

What cities are hiring for Insurance Claim Review jobs?

Cities with the most Insurance Claim Review job openings:

What states have the most Insurance Claim Review jobs?

States with the most job openings for Insurance Claim Review jobs include:

What are popular job titles related to Insurance Claim Review jobs?

For Insurance Claim Review jobs, the most frequently searched job titles are:

Insurance Claim Review jobs near you
Infographic showing various Insurance Claim Review job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 76% Full Time, 18% Part Time, and 5% Contract. Highlights an 84% Physical, 1% Hybrid, and 15% Remote job distribution, with an average salary of $48,885 per year, or $23.5 per hour.

Insurance Claim Coordinator (FT)

Whiteville, NC • On-site

Columbus Regional Healthcare System
See more jobs at Columbus Regional Healthcare Systemexternal

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Retirement

Re-posted 18 days ago

Job description

Job Opportunity At Columbus Regional Healthcare System

At Columbus Regional Healthcare System we offer professional growth and advancement for every employee. Working at CRHS allows you to have the intimate hospital feel while still being provided with the large healthcare system resources.

Job Description

Reviews unpaid third party payer claims and determines the reason why the claim is unpaid and arranges with the payer for the payment of the claim. Processes all correspondence and request for additional information from third party payers. Reviews all Explanation of Benefits (EOB's) to insure the hospital is paid appropriately. Provides guidance, direction, and training in claim payment techniques to other Patient Accounting employees.

Qualifications
  • High school graduate.
  • Proficient in use of basic office machines and computer applications.
  • Knowledge of third party insurance payer requirements including billing and follow up techniques, electronic claims processing, and government regulations.
  • Knowledge of medical terminology, medical record coding, and patient registration techniques.

Preferred: Associates degree in Business Administration.

Experience: A minimum of six months related experience in insurance claim processing and insurance claim follow up. Given training and on-the-job experience, incumbent should be proficient in the basic aspects of the job within three months

Perks + Benefits
  • CRHS Campus Gym (open 7 days a week)
  • Competitive Pay Rates
  • CRHS Campus Cafeteria
  • Company Swag
  • Comprehensive Benefit Package
  • Tuition Reimbursement
  • Matching Retirement Plan
  • Sign on Bonus (select positions)

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