ZipRecruiter

Log In

1

Integrated Claims Examiner Jobs (NOW HIRING)

MetroPlusHealth

Claims Examiner I

Manhattan, NY · Hybrid

$50K - $54K/yr

Position Overview The Claims Examiner I is responsible for the data entry and system adjudication ... Minimum 2 years' experience in the healthcare insurance industry with knowledge of integrated ...

MetroPlusHealth

Claims Examiner I

Manhattan, NY · On-site

$50K - $54K/yr

Position Overview The Claims Examiner I is responsible for the data entry and system adjudication ... Minimum 2 years' experience in the healthcare insurance industry with knowledge of integrated ...

JT2 Integrated Resources

Claims Examiner

Oakland, CA · On-site

We partner with our clients to provide fully customized and innovative solutions that integrate ... We are searching for highly motivated Claims Examiners to join our team! Under supervision of the ...

Lowe's

Senior Claims Examiner

Mooresville, NC

... integrating Lowe's culture, team training, and jurisdiction-specific training into the on-boarding process Conducts investigations of claims by interviewing claimants and witnesses, obtaining ...

Venbrook

Claims Examiner

Los Angeles, CA · On-site

Claims Examiner, Public Entity DEPARTMENT: Claims Services LOCATION: Onsite - Downtown LA COMPANY ... This integration has increased efficiency while maintaining the high-quality investigative services ...

Venbrook

Claims Examiner

Los Angeles, CA · On-site

Claims Examiner, Public Entity DEPARTMENT: Claims Services LOCATION: Onsite - Downtown LA COMPANY ... This integration has increased efficiency while maintaining the high-quality investigative services ...

KHS

Claims Examiner I

Bakersfield, CA · On-site

$21.15 - $26.44/hr

... integrated managed health care delivery system. About the role Under management direction ... Minimum of one (1) year medical Claims Examiner processing experience. Individual must have good ...

Reliance Matrix

LTD Claims Examiner II

South Portland, ME · On-site

$52K - $65K/yr

Adjudicates claims accurately and fairly in accordance with the contract, appropriate claim ... Calculates benefit payments, which may include partial disability benefits, integration with other ...

Rsli

LTD Claims Examiner II

Charleston, WV

$52K - $65K/yr

Adjudicates claims accurately and fairly in accordance with the contract, appropriate claim ... Calculates benefit payments, which may include partial disability benefits, integration with other ...

Rsli

LTD Claims Examiner II

South Portland, ME · On-site

$52K - $65K/yr

Adjudicates claims accurately and fairly in accordance with the contract, appropriate claim ... Calculates benefit payments, which may include partial disability benefits, integration with other ...

Venbrook

Senior Claims Examiner

Anaheim, CA · On-site

$69K - $89K/yr

Venbrook Claims brings together decades of specialized expertise by integrating respected legacy claims brands: Carl Warren & Company, DMA Claims, and OneSource Claims Management. Venbrook works ...

Venbrook

Senior Claims Examiner

Anaheim, CA · On-site

$69K - $89K/yr

Venbrook Claims brings together decades of specialized expertise by integrating respected legacy claims brands: Carl Warren & Company, DMA Claims, and OneSource Claims Management. Venbrook works ...

KHS

Claims Examiner I/II - Temporary

Bakersfield, CA · On-site

$22 - $23.10/hr

... claims payment-processing experience is required ***Hybrid/Remote*** About us Kern Health Systems ... integrated managed health care delivery system. About the role Under management direction ...

Nationalindemnity

Senior Claims Examiner I

Omaha, NE · On-site +1

$31.25 - $42.50/hr

Investigate assigned claims reported under insurance contracts provided by affiliated Companies ... Our Wellness program is integrated into the Company culture with an online wellness portal that ...

next page

Showing results 1-20

All JobsIntegrated Claims Examiner Jobs

Integrated Claims Examiner information

See salary details

$15

$29

$45

How much do integrated claims examiner jobs pay per hour?

As of Aug 5, 2026, the average hourly pay for integrated claims examiner in the United States is $29.40, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $35.10 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an integrated claims examiner, and why are they important?

To thrive as an Integrated Claims Examiner, you need a solid understanding of insurance policies, claims processing, and regulatory compliance, typically supported by a relevant degree or experience in insurance or healthcare. Familiarity with claims management systems, industry-specific software, and possibly certifications like AIC (Associate in Claims) is highly valuable. Attention to detail, strong analytical thinking, and clear communication are crucial soft skills for resolving claims efficiently and fairly. These skills and qualifications are essential to ensure accurate claim assessments, minimize errors, and maintain customer trust and regulatory compliance.

What is an integrated claims examiner?

An Integrated Claims Examiner is a professional responsible for reviewing, investigating, and processing insurance claims across multiple lines of coverage, such as health, disability, and workers’ compensation. They analyze documentation, verify the validity of claims, and ensure that payouts comply with policy terms and regulations. Integrated Claims Examiners often work with adjusters, healthcare providers, and claimants to resolve complex cases efficiently. Their role is essential in preventing fraud and ensuring fair outcomes for both insurers and policyholders.

What are some common challenges integrated claims examiners face when handling complex claims?

Integrated Claims Examiners often encounter challenges such as interpreting medical records, coordinating with multiple stakeholders, and ensuring compliance with evolving regulations. Balancing accuracy with efficiency is crucial, as thorough investigations must meet tight deadlines. Examiners frequently collaborate with healthcare professionals, policyholders, and legal teams, requiring strong communication skills and attention to detail. Staying updated on policy changes and best practices helps mitigate these challenges and supports successful claim resolutions.

What is the difference between Integrated Claims Examiner vs Claims Processor?

AspectIntegrated Claims ExaminerClaims Processor
CredentialsTypically requires insurance or claims processing certificationsOften requires basic insurance or claims processing knowledge
Work EnvironmentOffice setting, analyzing complex claimsOffice setting, processing claims data
Industry UsageUsed in insurance companies, healthcare, and government agenciesCommon in insurance and healthcare sectors
Job FocusReviewing, evaluating, and approving complex claimsEntering, verifying, and processing claims data

The Integrated Claims Examiner and Claims Processor roles both operate within insurance and healthcare industries, but the examiner focuses on evaluating complex claims, while the processor handles data entry and basic processing. Understanding these differences helps job seekers identify the right position based on their skills and career goals.

More about Integrated Claims Examiner jobs
What job categories do people searching Integrated Claims Examiner jobs look for? The top searched job categories for Integrated Claims Examiner jobs are:
Integrated Claims Examiner jobs near you
Infographic showing various Integrated Claims Examiner 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 $61,156 per year, or $29.4 per hour.

Claims Examiner I

MetroPlusHealth

Manhattan, NY • Hybrid

$50K - $54K/yr

Full-time

Posted 27 days ago

MetroPlusHealth rating

6.7

Company rating: 6.7 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

263rd of 301 rated insurance

Job description

Position Overview

The Claims Examiner I is responsible for the data entry and system adjudication of provider claims. The incumbent authorizes final disposition of claims within prescribed guidelines in an accurate and timely manner.

Scope of Role & Responsibilities:

  • Process claims involving medical and/or surgical services; screens for complete member/provider information
  • Apply administrative policies when necessary, utilizing the claims processing manuals
  • Authorizes the generation of letters/questionnaires to providers to obtain additional information
  • Reviews descriptions of services on claims to determine validity of charges of the presence of errors
  • Evaluates and examines claims pended by the system due to contractual and/or payment discrepancies
  • Maintains production and quality goals established for the department
  • Performs other related duties, i.e., maintaining individual production counts, updating manuals and reference materials, attending all refresher training seminars

Required Education, Training & Professional Experience

  • Associate’s Degree required; and
  • Minimum 2 years’ experience in the healthcare insurance industry with knowledge of integrated claims processing; or
  • A satisfactory equivalent combination of education, training, and experience
  • Proficiency with data entry skills
  • Through knowledge of medical terminology, CPT, ICD-p, and Revenue Codes

Professional Competencies

  • Integrity and Trust
  • Customer Focus
  • Functional/Technical skills
  • Written/Oral Communication

#LI-Hybrid

#MHP50

What MetroPlusHealth employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply