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Medical Adjudication Jobs (NOW HIRING)

OdysseyRe

Senior Claims Adjudicator

Stamford, CT · On-site

Knowledge of medical terminology, insurance benefits, and claims adjudication principles * Ability to interpret plan documents, contract provisions, eligibility requirements, and reimbursement ...

Odyssey

Senior Claims Adjudicator

Stamford, CT

Knowledge of medical terminology, insurance benefits, and claims adjudication principles * Ability to interpret plan documents, contract provisions, eligibility requirements, and reimbursement ...

OdysseyRe

Senior Claims Adjudicator

Stamford, CT · On-site

Knowledge of medical terminology, insurance benefits, and claims adjudication principles * Ability to interpret plan documents, contract provisions, eligibility requirements, and reimbursement ...

New

State of Delaware - Department of Labor

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Disability Determination Adjudicator I

New Castle, DE · On-site

$41K/yr

Authorizes payment of medical invoices. * Maintains up-to-date reference materials and manuals necessary to the adjudication process. JOB REQUIREMENTS for Disability Determination Adjudicator I ...

NaphCare

Senior Claims Adjudicator

Birmingham, AL

Minimum five years of recent adjudication experience required. * An ability to define and calculate Medicare and Medicaid is critical. * Working knowledge of medical terminology, billing standards ...

NaphCare

Senior Claims Adjudicator

Vestavia Hills, AL · On-site

Minimum five years of recent adjudication experience required. * An ability to define and calculate Medicare and Medicaid is critical. * Working knowledge of medical terminology, billing standards ...

Independent Health

Claims Adjudicator

Buffalo, NY · On-site

$18/hr

Knowledge of medical billing procedures; CPT and ICD-9 coding and medical terminology knowledge ... claims adjudication. * Analyze, identify and research, as needed, edits which demonstrate ...

UNITE HERE HEALTH

Claims Adjudicator III

Oak Brook, IL · On-site

$23.79 - $29.13/hr

Working knowledge and experience in medical claims adjudication, preferably in a multi-employer environment * Understanding of Medicare, Medicaid, ACA, DOL regulations, ERISA and HIPAA Education ...

Vermont Jobs

UC Claims Adjudicator II

Montpelier, VT · On-site

... adjudication of eligibility issues for benefits under the Vermont Unemployment Compensation law ... paid medical premium and a dental plan at no cost for employees and their families Work/Life ...

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Medical Adjudication information

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$36.5K

$164.7K

$337K

How much do medical adjudication jobs pay per year?

As of Jul 20, 2026, the average yearly pay for medical adjudication in the United States is $164,731.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,000.00 and $268,500.00 per year, depending on experience, location, and employer.

What is the difference between Medical Adjudication vs Medical Coding?

AspectMedical AdjudicationMedical Coding
Primary RoleReviewing and deciding insurance claim outcomes based on policy and medical documentationAssigning standardized codes to medical diagnoses and procedures for billing and record-keeping
Required CertificationsOften requires claims processing or adjudication certifications, knowledge of insurance policiesCertified Professional Coder (CPC), Certified Coding Specialist (CCS)
Work EnvironmentInsurance companies, healthcare providers, third-party payersHospitals, clinics, billing companies, insurance companies

Medical Adjudication involves evaluating insurance claims to determine coverage and payment, while Medical Coding focuses on translating medical services into codes for billing. Both roles require understanding healthcare documentation, but they serve different functions in the claims process.

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Senior Claims Adjudicator

Senior Claims Adjudicator

OdysseyRe

Stamford, CT • On-site

Full-time

Posted 4 days ago

Job description

Odyssey Reinsurance Company (OdysseyRe) is the global reinsurance arm of Odyssey Group, one of the world's leading providers of reinsurance and specialty insurance. OdysseyRe offers a broad range of property, casualty, and specialty reinsurance products, providing capital and risk management solutions for clients to efficiently manage economic risk, through a network of branch and representative offices across North America, Latin America, EMEA (Europe, Middle East & Africa), AsiaPacific and London.
OdysseyRe is an equal opportunity employer with excellent benefits and a strong commitment to providing training and opportunities for our staff. We provide employees an innovative, enriching environment and take great pride in their career growth.
OdysseyRe is rated A+ (Superior) by AM Best and AA- (Very Strong) by Standard and Poor's. Odyssey Group is a subsidiary of Fairfax Financial Holdings Limited, which is traded on the Toronto Stock Exchange under the symbol FFH.
Summary
Responsible for reviewing and adjudicating medical claims to ensure accurate, timely reimbursement, interpreting contract provisions and eligibility requirements, researching fee schedules, and collaborating with claims staff, underwriters, and brokers to resolve inquiries and support claims-related decisions.
Responsibilities
  • Adjudicate claims for timely review and appropriate reimbursement
  • Analyze claims data to determine eligibility and apply appropriate contract provisions to the medical facts of the claim
  • Work with claims staff, underwriters, and advise brokers on adjudication results and resolve claim inquiries
  • Provide support for inquiries on adjudication methods and outcomes to claims staff
  • Research and review state reimbursement fee schedules
  • Other support requirements, as necessary

Qualifications
  • Bachelor's degree (or equivalent college education)
  • 10+ years of claims adjudication, claims processing, health insurance, or related experience
  • Strong attention to detail and organizational skills
  • Knowledge of medical terminology, insurance benefits, and claims adjudication principles
  • Ability to interpret plan documents, contract provisions, eligibility requirements, and reimbursement guidelines
  • Clear written and verbal communication skills
  • Ability to work well independently as well as within a team environment
  • Proficiency (Microsoft Office Product Suite)

We are an E-Verify employer - all hired positions require successfully passing an E-Verify Check.
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