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Insurance Claims Examiner Jobs (NOW HIRING)

Securian Financial

Claims Examiner

Saint Paul, MN

$18.80 - $32.69/hr

As a Claims Examiner, you will investigate, evaluate, and adjudicate claims while balancing ... Experience adjudicating insurance claims. * Ability to navigate sensitive situations with empathy ...

Securian Financial

Claims Examiner

Saint Paul, MN · On-site

$18.80 - $32.69/hr

As a Claims Examiner, you will investigate, evaluate, and adjudicate claims while balancing ... Experience adjudicating insurance claims. * Ability to navigate sensitive situations with empathy ...

Trawick International Inc

Claims Examiner

Miami, FL · On-site

Claims Examiner Department: Claims Reports to: Claims Supervisor Date: Job Summary Are you looking ... Read and interpret insurance policy language and adjudicate claims accordingly * Respond to written ...

Next Step Systems

Medical Claims Examiner

Tucson, AZ · On-site

The Medical Claims Examiner is also responsible for monitoring copays, deductibles, insurance verification, and authorizations, analyzing incoming and outgoing revenue sources and measuring different ...

University Health

Claims Examiner

San Antonio, TX

We are looking for an experienced Claims Examiner for our Claims department with Community First ... and CHIP (Children's Health Insurance Program) according to departmental and regulatory ...

Next Step Systems

Medical Claims Examiner

Tucson, AZ · On-site

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

Next Step Systems

Medical Claims Examiner

Tucson, AZ · On-site

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

Trident

Medical Claims Examiner

$30/hr

We are seeking a highly skilled and independent Claims Examiner to join our team on a 100% remote ... insurance claims. Because this is a fully remote, independent contractor position, we are looking ...

JT2 Integrated Resources

Claims Examiner

Oakland, CA · On-site

We are searching for highly motivated Claims Examiners to join our team! Under supervision of the ... Possession of a current Self-Insurance Plan (SIP) Certificate and insurance-related course work:

Lowe's

Senior Claims Examiner

Mooresville, NC · On-site

... claims examiners on a team, focusing on bodily injury or property damage in a particular ... North Carolina insurance adjuster license About Lowe's Lowe's Companies, Inc. (NYSE: LOW) is a ...

Richmond National

Claims Examiner

Glen Allen, VA · On-site

$65K - $85K/yr

Job Title: Claims Examiner Location: Full time in-office, Richmond, VA 23233 We are seeking a ... Strong knowledge of commercial liability insurance policies, coverage analysis, and claims handling ...

Kinsale Insurance

Claims Examiner

Richmond, VA · On-site

$73K - $90K/yr

As a Claims Examiner, you will play a key role in managing casualty claims from investigation ... Comprehensive Benefits - Health, dental, and vision insurance with up to $3,600 (individual) or $6 ...

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Insurance Claims Examiner information

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$61.6K

$92K

How much do insurance claims examiner jobs pay per year?

As of Aug 12, 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.

How much do insurance claims examiners make in the US?

Insurance claims examiners in the US earn a median annual salary of around $45,000 to $70,000, depending on experience, location, and employer. Those with specialized skills or certifications may earn higher wages, and the role often involves reviewing claims, assessing damages, and ensuring compliance with policies.

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.

How to become an insurance claims examiner?

To become an insurance claims examiner, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary education or relevant experience. Many employers require knowledge of insurance policies, claims processing, and strong attention to detail; professional certifications such as the Certified Claims Professional (CCP) can enhance job prospects.

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:
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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 August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 21% Part Time, and 5% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $61,600 per year, or $29.6 per hour.

Claims Examiner

Texas Children's Hospital

Bellaire, TX

Full-time

Re-posted 12 days ago

Texas Children's Hospital rating

8.3

Company rating: 8.3 out of 10

Based on 174 frontline employees who took The Breakroom Quiz

80th of 1,058 rated hospitals

Job description

We are looking for a Claims Examiner, someone who's ready to grow with our company. In this position, you will process and adjudicate claims received for reimbursement to Providers based on extensive review, research, and a detailed format of claim processing procedures. 
Think you've got what it takes? 
Job Duties & Responsibilities 
    Adjudicate claims received into processing system. 
    Thoroughly reviews, investigates, and adjudicates claims daily, working oldest to newest claim in 30 days or less, and 98% of the time. 
    Examiners should process at least 14 claims per hour, or 98 claims per day. 
    Conducts review and investigation of pended claims and follow up with internal and external departments to finalize claims resolution within 30 days. 
    Macess requests are processed within 30 days of receipt, with a 98% accuracy, to ensure timely resolution of claims, in adherence with HHSC regulatory requirements. 
    The claims are processed accurately as defined by standard guidelines. 
    The claims should be adjudicated with a 98% procedural accuracy rate monthly as reviewed by weekly audit reports. 
    The claims should be adjudicated with a 98% accuracy rate monthly as reviewed by returned claims for adjustment review. 
    The claims that are manually adjudicated must have notes entered as reviewed by weekly audits, check run, returned claims, management review 98% of the time. 
    Clear concise documentation/notes must be entered for each claim reviewed, which provides a historical reference of how the claim was processed at the time of adjudication. 
    Complete special projects as requested. 
Skills & Requirements 
    Required H.S. Diploma or GED 
    Required 1 year claims examination experience 
 

Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.

Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

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