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Insurance Claims Nurse Jobs (NOW HIRING)

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Claims Specialist

Charleston, WV · Remote

We're backed by industry leaders in insurance and tech, and we still have room to grow -- that ... Work with nurses, doctors, and attorneys on file reviews * Comply with all statutory and regulatory ...

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Insurance Claims Nurse information

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$12

$23

$43

How much do insurance claims nurse jobs pay per hour?

As of Jul 29, 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:
What job categories do people searching Insurance Claims Nurse jobs look for? The top searched job categories for Insurance Claims Nurse jobs are:
Insurance Claims Nurse jobs near you
Infographic showing various Insurance Claims Nurse job openings in the United States as of July 2026, with employment types broken down into 90% Full Time, 8% Part Time, and 2% 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 Claims Representative

American Express

Phoenix, AZ • On-site

$20 - $24.05/hr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 7 days ago

American Express rating

8.6

Company rating: 8.6 out of 10

Based on 37 frontline employees who took The Breakroom Quiz

23rd of 150 rated financial services

Job description


AMEX Assurance Co. (AAC) provides insurance protection for American Express Card Members through implicit card benefits, and fee/add-on insurance products to both Card Members and non-Card Members. This role provides an exciting opportunity to handle claims for the Retail products with growth into specialty lines products in the AMEX Assurance Co. Insurance portfolio over time.
Responsibilities
  • Investigation of policy and product information by using tools available.
  • Maintaining state compliance for reporting, Medicare, insurance claims and audit functions relative to the AAC claims team related to claims adjudication.
  • Decision making of claims for these products, as well as direct phone interaction with the customer to ensure timely decisions
  • Researching claims for proper disposition which may include communication via phone and/or written correspondence with customers, businesses and others.
  • Adjudication of claims relative to all state and local laws and compliance as well as internal processes and procedures.
  • This position is based in Phoenix, AZ or Sunrise, FL and the ideal candidate will work a minimum of 3 days onsite / 2 days remotely. The ideal candidate will work a flexible schedule between the hours of operation: Monday - Friday - 6:00am - 5:00pm MST and may be asked to work rotational weekends.

Qualifications
Minimum Qualifications:
  • Customer First Principles demonstrated through excellent verbal, written and interpersonal communication skills
  • High School Diploma or Higher-level education.
  • Passion for exceptional service
  • Strong phone skills
  • Ability to adapt to multiple demands, shifting priorities and rapid changes in workflow
  • Ability to demonstrate initiative with minimal supervision to drive results
  • Strong problem-solving skills, time management and organizational skills
  • Superior level of accuracy and attention to detail.
  • Strong proficiency in PC skills, including MS Word and Excel
  • 1 year of Insurance or Customer Service industry experience
  • A current Claims Adjuster License is a plus.
    Additional Requirements:
  • If a license is not currently held, the applicant must be able to obtain the necessary license during the time frame allowed prior to training. Upon hiring, candidates will have 3 attempts to pass the 1336-Arizona Property and Casualty Adjuster Licensing Exam. If the exam to obtain your license cannot be passed, within 3 attempts, employment will be terminated
  • For FL Candidates: If a license is not currently held, the applicant must be able to obtain the necessary license during the time frame allowed prior to training. Upon hiring, candidates will have 3 attempts to pass the Ins FL- ALJ16:FLA All Lines Adjuster (0620,0720,7020) Licensing Exam. If the exam to obtain your license cannot be passed, within 3 attempts, employment will be terminated.
    Employment eligibility to work with American Express in the United States is required as the company will not pursue visa sponsorship for these positions.

About Us
At American Express, our culture is built on a 175-year history of innovation, shared values and Leadership Behaviors, and an unwavering commitment to back our customers, communities, and colleagues. From delivering differentiated products to providing world-class customer service, we operate with a strong risk mindset, ensuring we continue to uphold our brand promise of trust, security, and service.
As part of Team Amex, you'll experience our powerful backing with comprehensive support for your holistic well-being and many opportunities to learn new skills, develop as a leader, and grow your career. Here, your voice and ideas matter, your work makes an impact, and together, you will help us define the future of American Express.
About the Team
We back you with benefits that support your holistic well-being so you can be and deliver your best. This means caring for you and your loved ones' physical, financial, and mental health, as well as providing the flexibility you need to thrive personally and professionally:
  • Competitive base salaries
  • Bonus incentives
  • 6% Company Match on retirement savings plan
  • Free financial coaching and financial well-being support
  • Comprehensive medical, dental, vision, life insurance, and disability benefits
  • Flexible working model with hybrid, onsite or virtual arrangements depending on role and business need
  • 20+ weeks paid parental leave for all parents, regardless of gender, offered for pregnancy, adoption or surrogacy
  • Free access to global on-site wellness centers staffed with nurses and doctors (depending on location)
  • Free and confidential counseling support through our Healthy Minds program
  • Career development and training opportunities

For a full list of Team Amex benefits, visit our Colleague Benefits Site.
American Express is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other status protected by law. American Express will consider for employment all qualified applicants, including those with arrest or conviction records, in accordance with the requirements of applicable state and local laws, including the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance for Employers, and the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance. For positions covered by federal and/or state banking regulations, American Express will comply with such regulations as it relates to the consideration of applicants with criminal convictions.
We back our colleagues with the support they need to thrive, professionally and personally. That's why we have Amex Flex, our enterprise working model that provides greater flexibility to colleagues while ensuring we preserve the important aspects of our unique in-person culture. Depending on role and business needs, colleagues will either work onsite, in a hybrid model (combination of in-office and virtual days) or fully virtually.
US Job Seekers - Click to view the "Know Your Rights" poster. If the link does not work, you may access the poster by copying and pasting the following URL in a new browser window: https://www.eeoc.gov/poster.
The below represents the expected salary range for this job requisition. Ultimately, in determining your pay, we'll consider your location, experience, and other job-related factors.

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