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Insurance Claims Nurse Jobs (NOW HIRING)

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Insurance Claims Nurse information

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$12

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How much do insurance claims nurse jobs pay per hour?

As of Jul 7, 2026, the average hourly pay for insurance claims nurse 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.

Do insurance companies hire nurses?

Yes, insurance companies often hire nurses for roles such as claims review, case management, and medical underwriting. These positions typically require clinical knowledge, strong communication skills, and sometimes certification or licensure in nursing.

How does an Insurance Claims Nurse typically collaborate with other professionals during the claims review process?

Insurance Claims Nurses work closely with claims adjusters, physicians, and case managers to evaluate the medical aspects of insurance claims. They review medical records, assess treatment plans, and provide expert opinions on the necessity and appropriateness of care. Effective communication and teamwork are essential, as their input helps determine coverage decisions and ensures that claims are processed efficiently and fairly. This collaborative environment allows for shared expertise and often presents opportunities to learn from other professionals in the insurance and healthcare fields.

What does an Insurance Claims Nurse do?

An Insurance Claims Nurse, also known as a nurse case manager or nurse reviewer, evaluates medical claims submitted to insurance companies. They review medical records to ensure that treatments and procedures are medically necessary and covered under the patient's insurance policy. These nurses use their clinical expertise to interpret medical information, communicate with healthcare providers, and help determine the appropriate level of care or coverage. Their work helps prevent fraud and ensures that claims are processed accurately and efficiently.

How to make an extra $1000 a month as a nurse?

Insurance claims nurses can increase their income by taking on additional part-time or freelance work, such as consulting or providing expert reviews for insurance companies. Developing specialized skills in claims processing, certification in insurance or legal nursing, and working flexible hours can help reach extra income goals. Leveraging experience and certifications can also open opportunities for higher-paying roles or side projects.

How to make $300,000 as a nurse?

An insurance claims nurse can increase earnings by gaining specialized certifications, such as Certified Case Manager (CCM), and gaining experience in high-paying sectors like workers' compensation or disability claims. Working overtime, taking on leadership roles, or pursuing advanced education can also boost income, but reaching $300,000 typically requires a combination of experience, specialization, and possibly working in managerial or consulting positions.

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

AspectInsurance Claims NurseInsurance Adjuster
Required CredentialsRN license, possibly certifications in case management or insuranceState licensing, insurance certifications (e.g., AIC, CPCU)
Work EnvironmentHospitals, clinics, insurance companies, telehealthInsurance companies, claims offices, field work
Employer & Industry UsageHealthcare and insurance sectorsInsurance industry, claims processing
Common Search & Comparison IntentUnderstanding healthcare-related claims and patient careEvaluating claims, assessing damages, settling insurance claims

Insurance Claims Nurses focus on healthcare-related claims, utilizing nursing skills to evaluate patient needs, while Insurance Adjusters assess damages and process claims for insurance companies. Both roles require industry-specific certifications and work within the insurance sector, but their daily tasks and environments differ significantly.

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

To thrive as an Insurance Claims Nurse, you need a valid nursing license, clinical experience, and a solid understanding of medical terminology and insurance processes. Familiarity with claims management software, electronic health records (EHRs), and sometimes certification in case management (such as CCM) are typically required. Strong analytical thinking, attention to detail, and effective communication skills help you accurately evaluate claims and collaborate with patients, providers, and insurers. These competencies are essential to ensure fair, timely claims resolution and maintain compliance with healthcare and insurance regulations.

How to make $150,000 as a nurse?

An Insurance Claims Nurse can reach a $150,000 salary by gaining specialized certifications, such as Certified Claims Professional, and accumulating extensive experience in insurance claim processing. Working in high-demand regions, taking on leadership roles, or specializing in complex claims can also increase earning potential. Advanced skills in documentation, negotiation, and understanding insurance policies are essential for higher compensation.
More about Insurance Claims Nurse jobs
What cities are hiring for Insurance Claims Nurse jobs? Cities with the most Insurance Claims Nurse job openings:
What are the most commonly searched types of Insurance Claims Nurse jobs? The most popular types of Insurance Claims Nurse jobs are:
What states have the most Insurance Claims Nurse jobs? States with the most job openings for Insurance Claims Nurse jobs include:
Medical Insurance Claims Representative

Medical Insurance Claims Representative

HCA Healthcare

Englewood, CO • On-site

$19.84 - $29.76/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago


HCA Healthcare rating

6.4

Company rating: 6.4 out of 10

Based on 2,222 frontline employees who took The Breakroom Quiz

636th of 877 rated healthcare providers


Job description

Hourly Wage Estimate: $19.84 - $29.76 / hour
Learn more about the benefits offered for this job.

The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

Do you want to join an organization that invests in you as a Medical Insurance Claims Representative? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

*This position is Full-time with required on-site orientation/training in our Denver, CO office and the possibility to work from home after meeting and maintaining productivity standards.

Job Summary and Qualifications

As the Medical Insurance Claims Representative, you will contribute to the company’s mission, vision, and values by completing follow-up and collections for patient services. Under the supervision of the Business Office Manager/Business Office Supervisor, you will obtain payment from third party payers and self-pay accounts to enhance cash flow and gather reimbursement based on established contracts.

What you will do in this role:

  • You will perform follow up activities on accounts to ensure prompt payment
  • You will identify coding or billing errors from EOBs and work to correct them
  • You will monitor insurance claims and contact insurance companies to resolve claims
  • You will update the patient account record to identify actions taken
  • You will assign bad debt accounts to the collection agency
  • You will act as a liaison and administer contracts in collection of third party accounts (Medicare and Medicaid)
  • You will complete account reconciliation of accounts turned over to outside agencies
  • You will negotiate payment plans on self-pay accounts
  • You are responsible for maintaining accounts receivable and creating a reduction in bad debt

Qualifications you will need:

  • Minimum (1) year of experience in a medical office setting highly preferred. (i.e. ambulatory surgery center, hospital, doctors office) preferred
  • Knowledge of managed care payers and medical terminology is preferred
Benefits

HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
  • Wellbeing support, including free counseling and referral services
  • Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
  • Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
  • Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
  • Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Consider a fulfilling and secure career with Surgery Ventures, in partnership with HCA Healthcare. Our team of over 3,400 physicians manages more than 150 surgery centers across 16 states in the United States. As a dedicated unit within HCA Healthcare, we prioritize providing safe, efficient, and premium surgical services. With over 30 years of pioneering experience in the industry, our physician partners offer exceptional outpatient care to over 800,000 patients in communities across our network. We do so with the backing of the clinical, operational, and financial expertise of a Fortune 100 healthcare leader. At Surgery Ventures, we are committed to supporting your career growth and advancement at every stage.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses


"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Medical Insurance Claims Representative opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.


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