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Insurance Claims Examiner Jobs (NOW HIRING)

Relation Insurance

Claims Examiner

Tulsa, OK · On-site

WHO WE ARE Relation Insurance is a leading, innovative company with a strong commitment to ... The Claims Examiner must demonstrate strong interpersonal, analytical, and organizational skills ...

Next Step Systems

Claims Examiner

Tucson, AZ · On-site

Monitor copays, deductibles, insurance verification, and authorizations. Analyze incoming and ... Claims Examiner Responsibilities: - Submit claims and encounters in a timely manner. - Review and ...

Sigma Systems, Inc.

Claims Examiner

Irving, TX

9141569- Claims Examiner Irving, TX 3 Months contract Sigma Inc. is currently looking for a Claims ... Follow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act ...

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Network Adjusters, Inc.

Claims Examiner

Denver, CO · On-site

$85K - $125K/yr

Network Adjusters is seeking experienced Claims Examiners to join our third-party administrative insurance handling team in a file review role. This is a high-visibility position reporting directly ...

Relationinsurance

Claims Examiner

Tulsa, OK

WHO WE ARE Relation Insurance is a leading, innovative company with a strong commitment to ... The Claims Examiner must demonstrate strong interpersonal, analytical, and organizational skills ...

Key Staffing, Inc

Be Seen First

Claims Examiner

Bakersfield, CA · On-site

$22 - $23.10/hr

Claims Examiner I / II Location: Bakersfield, CA Pay: $22-$23.10/hr Schedule: Full-Time Employment ... Verify member eligibility and insurance coverage through online systems and other resources.

Wellcove

Claims - Claims Examiner

Pensacola, FL · On-site

Our solutions span the insurance senior market sector, focusing on long-term care and Medicare ... The Long-Term Care (LTC) Claims Examiner is responsible for the accurate and timely adjudication of ...

TEKsystems

Claims Examiner

Santa Barbara, CA · Remote

$23 - $25/hr

Prior experience within a healthcare payer, insurance, or managed care environment. Key Skills * Claims Examination * Medical Claims Processing * Claims Adjudication * Claims Denials Management

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Insurance Claims Examiner information

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$40K

$61.6K

$92K

How much do insurance claims examiner jobs pay per year?

As of Jul 1, 2026, the average yearly pay for insurance claims examiner in the United States is $61,600.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,000.00 and $65,500.00 per year, depending on experience, location, and employer.

What does an Insurance Claims Examiner do?

An Insurance Claims Examiner is responsible for reviewing insurance claims to determine their validity and ensure that payouts are made according to policy guidelines. They investigate the details of claims, verify information, and may consult with medical or legal experts. The examiner determines if claims are covered, recommends approval or denial, and helps prevent fraudulent or excessive claims. Their work ensures that policyholders receive fair treatment while protecting the insurance company's financial interests.

What is the difference between Insurance Claims Examiner vs Insurance Adjuster?

AspectInsurance Claims ExaminerInsurance Adjuster
CredentialsTypically requires a high school diploma or equivalent; some roles prefer certifications like CPCU or AICRequires similar credentials; certifications like AIC or CPCU are common
Work EnvironmentOffice-based, reviewing claims and documentationField or office-based, inspecting damages and interviewing claimants
Employer & IndustryInsurance companies, government agenciesInsurance companies, independent adjusting firms
Search & Comparison IntentOften compared for claims processing rolesRelated to claims evaluation and damage assessment

Both Insurance Claims Examiners and Insurance Adjusters work within the insurance industry, handling claims and requiring similar certifications. While Claims Examiners primarily review documentation in office settings, Adjusters often inspect damages in the field. Understanding these differences helps job seekers identify the right role based on work environment and responsibilities.

What are some common challenges Insurance Claims Examiners face in their daily work?

Insurance Claims Examiners often encounter the challenge of balancing thorough investigation with timely claims processing. Reviewing complex documentation, communicating with claimants and other stakeholders, and detecting potential fraud can be demanding, especially when managing a high-volume caseload. Examiners must stay updated on changing regulations and policy guidelines while maintaining objectivity and empathy in sometimes stressful situations. Developing strong organizational and communication skills is key to overcoming these challenges and delivering fair, accurate outcomes.

What are the key skills and qualifications needed to thrive as an Insurance Claims Examiner, and why are they important?

To thrive as an Insurance Claims Examiner, you need a solid understanding of insurance policies, claim procedures, and investigative techniques, typically supported by a bachelor's degree in a related field. Familiarity with claims management software, regulatory compliance tools, and sometimes certifications like AIC (Associate in Claims) are commonly required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for evaluating claims and interacting with claimants and stakeholders. These skills ensure accurate claim assessments, minimize fraudulent payouts, and maintain trust with clients and insurers.
More about Insurance Claims Examiner jobs
What cities are hiring for Insurance Claims Examiner jobs? Cities with the most Insurance Claims Examiner job openings:
Who are the top companies hiring for Insurance Claims Examiner jobs? The top employers for Insurance Claims Examiner jobs are:
What states have the most Insurance Claims Examiner jobs? States with the most job openings for Insurance Claims Examiner jobs include:
What job categories do people searching Insurance Claims Examiner jobs look for? The top searched job categories for Insurance Claims Examiner jobs are:
What are popular job titles related to Insurance Claims Examiner jobs? For Insurance Claims Examiner jobs, the most frequently searched job titles are:
Insurance Claims Examiner jobs near you
Infographic showing various Insurance Claims Examiner job openings in the United States as of June 2026, with employment types broken down into 76% Full Time, and 24% Part Time. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $61,600 per year, or $29.6 per hour.
Claims Examiner

Claims Examiner

Relation Insurance

Tulsa, OK • On-site

Full-time

Medical, Retirement, PTO

Posted 27 days ago

Relation Insurance rating

7.1

Company rating: 7.1 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

227th of 277 rated insurance

Job description

WHO WE ARE
Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environment, and continuous drive for success. With a rich history and a bright future ahead, we are looking for exceptional individuals to join our team and contribute to our ongoing growth and success.
WHAT WE'RE LOOKING FOR
The Claims Examiner is responsible for verifying, adjusting, and resolving insurance claims. The individual in this role serves clients and providers by ensuring claims are processed accurately, efficiently, and in compliance with company policies and regulatory requirements. The Claims Examiner must demonstrate strong interpersonal, analytical, and organizational skills, and be able to communicate effectively with a variety of stakeholders.
A GLIMPSE INTO YOUR DAY
  • Reviews and validates claims for accuracy, completeness, and eligibility based on policy terms and guidelines.
  • Analyzes, adjudicates, and resolves claims by approving or denying documentation, calculating benefit amounts, and initiating payments or composing denial letters.
  • Ensures legal compliance with company policies, procedures, and applicable state and federal regulations throughout the claims process.
  • Maintains accurate records of claims, settlements, denials, and related documentation.
  • Addresses questions and concerns from providers, clients, and internal personnel regarding the adjudication process.
  • Reports overpayments, underpayments, and irregularities to supervisors.
  • Communicates with reinsurance brokers and other stakeholders to obtain necessary information for claim processing.
  • Verifies member eligibility, benefit coverage, and authorizations as needed.
  • Protects confidential information and ensure HIPAA compliance.
  • Identifies documentation gaps or discrepancies and coordinates resolution as needed.
  • Supports quality, accuracy, and consistency in claims processing through adherence to policies and procedures.
  • Effectively utilizes available technology and tools, including emerging and AI-enabled solutions, to support efficient workflows, accuracy, and a positive client service experience.
  • Special projects and other duties as assigned.

WHAT SUCCESS LOOKS LIKE IN THIS ROLE
  • High school diploma or equivalent required.
  • Minimum 1 year of healthcare reimbursement or claims processing experience.
  • Ability to read, analyze, and interpret company guidelines, benefit documentation, and government regulations.
  • Intermediate computer skills, including email, database activity, word processing, and spreadsheets.
  • Ability to handle multiple tasks simultaneously and adapt to changing priorities.
  • Strong analytical, problem-solving, and communication skills.

WHY CHOOSE RELATION?
  • Competitive pay.
  • A safe and healthy work environment provided by our robust benefit program including family health and wellness programs, 401K, employee assistance programs, paid time off, paid holidays and more.
  • Career advancement and development opportunities.

Note: The above is not all encompassing of the full position description.
Relation Insurance Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Relation, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is presented within this posting.
You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance.
$15.38 - $32.21

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