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Insurance Claim Review Jobs (NOW HIRING)

Capital Claims Group

Be Seen First

Claims Support Administrator

Miramar, FL · On-site

$20 - $25/hr

... insurance companies, attorneys, contractors, and vendors * Follow up on outstanding claim documentation * Schedule inspections, meetings, mediations, appraisals, and recorded statements * Review ...

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Capital Claims Group

Be Seen First

Claims Support Administrator

Miramar, FL · On-site

$20 - $25/hr

... insurance companies, attorneys, contractors, and vendors * Follow up on outstanding claim documentation * Schedule inspections, meetings, mediations, appraisals, and recorded statements * Review ...

New

Chubb

Senior Claim Examiner-Casualty

Chicago, IL · On-site

$79K - $134K/yr

... review meetings with our customers, management and business partners, in addition to being a U.S. claim resource to our global claim offices and underwriters. Chubb is a world leader in insurance.

The MH Group

Claims Compliance Analyst

East Longmeadow, MA · On-site

$60K - $70K/yr

Review all claim-related compliance reports to ensure accuracy. * Scrub pay-related reports to ... A minimum of 5 years of experience in health insurance claim processing is required . * Capacity to ...

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Insurance Claim Review information

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$43

How much do insurance claim review jobs pay per hour?

As of Jul 11, 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 81% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $48,885 per year, or $23.5 per hour.

Insurance Billing Specialist, Full-time

Hopedale MC

Hopedale, IL • On-site

$18 - $23/hr

Full-time

Re-posted 6 days ago

Job description

Insurance Billing Specialist, Onsite
We are currently looking for experienced Insurance Billing Specialist!
Must be willing to reasonably commute to Hopedale IL, this is not a remote position.
Job Preview
Obtain accurate, ethical, and optimal reimbursement for hospital and hospital-based services, initiate follow-up of past due balances, handle all components of claims processing including management of disputed, rejected, and delayed claims. Develop a thorough understanding of third-party reimbursement requirements. Enter and electronically or hard copy submit billing data, as necessary. Know and understand all policies and procedures of Insurance Billing. Must be a problem solver, have organizational skills, attention to detail, excellent telephone technique and rapport, and computer knowledge.
Responsibilities:
1 Insurance Claim Billing
  • Reviews patient accounts and verifies data for correct billable services and fees. Ensures all pertinent billing information is documented to produce a clean UB-04 claim.
  • Runs daily insurance billing reports and reviews discrepancies. Corrects accounts, as necessary.
  • Generated Medicare, Medicaid, and Commercial Insurance claims via electronic and hard copy processes.
  • Prior to submission, reviews each claim for accuracy and missing information. Transmits claims electronically to TruBridge.

2 Insurance Claim Follow up
  • Follow up on any unpaid claim.
  • Follow-up on insurance denials and takes appropriate steps to resolve discrepancies.
  • Communicates discrepancies and the need for additional information to the appropriate parties. Obtain supporting documentation to appeal claim payment.
  • All collection and follow-up efforts will be annotated in the CPSI computer System.
  • Re-bill accounts as needed.

3 Ensure accurate Insurance Payments are received
  • Receive daily incoming payments and prepare for posting. Review explanation of benefits and verify patient information, payer, and date of service for all transactions.
  • Audit payments against contract terms.
  • Compute contractual allowances as needed.
  • Non-collectible accounts will be forwarded to the Revenue Cycle Director as soon it is determined they are non-collectible with supporting documentation to be written off.
  • Assists patients and insurance companies with questions regarding billing procedures, charges, insurance reimbursement, copies of itemized statements, split billings, payments in office, etc.

4 Accounts Receivable Management
  • Monitor and maintain assigned Accounts Receivable at minimal levels.
  • All assigned accounts are regularly worked and followed up on.
  • Ensure any credit balances are resolved and generate refund requests for over payment as soon as possible.

5 Other Duties as Assigned
  • Keep updated on all third-party billing requirements. Serves as a resource person for staff inquiries regarding billing issues.
  • Assists with training of staff as necessary.
  • Other duties as assigned.

Knowledge/Skill/Ability Requirements:
  • Minimum of High School Diploma. Some college preferred.
  • Knowledge of Medicare Part A, Medicaid, and Insurance Procedures.
  • Knowledge of medical billing /collection procedures.
  • Prefer 1-2 years in medical business office including Insurance Claim follow up.
  • Demonstrated working knowledge of a computerized medical information management system.
  • Skills in Microsoft Office Suite (Word, Excel, Outlook).
  • Good verbal and written communication skills required.
  • Ability to work independently with only general supervision.
  • Great attention to detail required along with a high level of dependability.
  • Excellent telephone techniques and rapport.
  • Ability to effectively communicate and interact with colleagues, hospital staff, patients, physicians and their staff, and third-party insurance personnel.

Pay Range: $18 - $23 per hour

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