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Insurance Claim Review Jobs (NOW HIRING)

Highlands Hospital

Insurance Claim Biller

NV · On-site

... Insurance Claim Biller familiar with claim submissions to insurance companies and experience ... Review and process claims in various stages of revenue cycle in a timely manner. B Resolve ...

New

Reliant Medical Group

IRR Clinical Claim Review | , |

$29 - $52/hr

Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability ... claim review, appeals review, or medical record review * Intermediate level of computer skills ...

New

Selene Holdings

Insurance Claims Specialist

Dallas, TX · On-site

... insurance brokerage, and a real estate owned company. We have office locations in Dallas, TX, ... Prepare management reports summarizing claim review outcomes, payment accuracy, and performance ...

UnitedHealthcare

Clinical Claim Review | , |

$29 - $52/hr

A background in utilization review for an insurance company or experience in case management * Familiarity with Milliman Care Guidelines Soft Skills * Critical thinking skills *All employees working ...

divvyDOSE

Clinical Claim Review | , |

$29 - $52/hr

A background in utilization review for an insurance company or experience in case management * Familiarity with Milliman Care Guidelines Soft Skills * Critical thinking skills *All employees working ...

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 ...

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 ...

UnitedHealth Group

Clinical Claim Review RN

Boston, MA · Remote

$29 - $52/hr

A background in utilization review for an insurance company or experience in case management * Familiarity with Milliman Care Guidelines Soft Skills: * Critical thinking skills *All employees working ...

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Insurance Claim Review information

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How much do insurance claim review jobs pay per hour?

As of Jul 31, 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 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.

What are the key skills and qualifications needed to thrive as an Insurance Claim Review Specialist, and why are they important?

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 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 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.
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 job categories do people searching Insurance Claim Review jobs look for? The top searched job categories for Insurance Claim Review jobs are:
Insurance Claim Review jobs near you
Infographic showing various Insurance Claim Review job openings in the United States as of July 2026, with employment types broken down into 79% Full Time, 19% Part Time, 1% Temporary, and 1% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $48,885 per year, or $23.5 per hour.

Insurance Claim Biller

Highlands Hospital

NV • On-site

Other

Posted yesterday

New

Job description

POSITION SUMMARY
(General statement reflecting the overall purpose of the position)
Humboldt General Hospital is looking for an experienced Insurance Claim Biller familiar with claim submissions to insurance companies and experience working with SSI. This candidate will be responsible for submitting correct or self-corrected claims, working patients encounters via established work queues and communicating and coordinating with revenue cycle colleagues. Attention to detail and superior customer service skills is necessary.
TASK LETTER CODE
PRIMARY DUTIES
(Are the essential job tasks or primary responsibilities that the individual who holds the position mist be able to perform unaided or with the assistance of an accommodation. For example: "DO" (action verb) + "WHAT" (object) - "Collects vitals from patients at the being of the visit according to clinic protocol".
% OF TIME PERFORMING DUTY
A
Submit correct clean claim to payors, or submit correction, of UB and/or 1500 claims forms. Review and process claims in various stages of revenue cycle in a timely manner.
B
Resolve encounters assigned via work queues and apply action when appropriate
C
Review claim edits from front and back-end scrubbers to reduce denials
D
Review edits received from SSI, correct claim and regenerate as appropriate.
E
Receives and takes calls from patients with insurance information updates such as COB
F
Receive, and take, Inbound and outbound calls with government payors and commercial insurance payors
G
Prepare and file insurance appeals in a timely manner
H
Work AR as assigned.
I
Modify charge grouping and registration when necessary for proper claim submission
J
Manage SSI web portal to include generating reports, working timely filing claims and troubleshooting claim submissions. Identify and log trending claim denials.
K
Maintains confidentiality adheres to all HIPAA guidelines/regulations
L
Other related duties as assigned.
M
N
O
POSITION QUALIFICATIONS
MINIMUM EDUCATION: High School diploma or General Education Degree
PREFERRED EDUCATION:
MINIMUM EXPERIENCE: Basic knowledge of third-party insurance plans billing.
REQUIRED CERTIFICATIONS:
PREFERRED CERTIFICATIONS/LICENSES: CRCR
SPECIAL SKILLS: Cerner Community Works/Revenue Cycle and SSI experience is preferred. Excellent command of written and spoken English; must be able to communicate effectively when in contact with insurance carriers, third-party payers and patients. Must be able to learn and understand patient accounting policies and procedures and how the EHR computer system works. Intermediate knowledge of Microsoft Word and Excel and the ability to learn new programs and systems is necessary. Dependable in both productivity and attendance.
SUPERVISES: None
PHYSICIAL DEMANDS: For physical demands and working conditions, see next page.

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