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Medical Adjuster Jobs (NOW HIRING)

Wilson-McShane Corp

MEDICAL CLAIMS ADJUSTER

Duluth, MN · On-site

$24/hr

As a Medical Claims Adjuster with Wilson-McShane Corporation, you will be processing medical, and short-term disability claims. This position has direct impact on the participants and families of the ...

Larkin Community Hospital

Medical Claim Adjuster

Miami, FL · On-site

$63K - $81K/yr

Medical Claim Adjuster DEPARTMENT: Patient Accounts SUPERVISOR: Business Office Director Larkin Health System is an integrated healthcare delivery system accredited by the Joint Commission with ...

Pridestaff

Machine Operator/Adjuster

Marietta, GA · On-site

$17 - $20/hr

Machine Operator/Adjuster Shift/Hours: Training - Monday - Friday, 8:00 am - 5:00 pm (4 weeks in ... Medical, Rx, and Wellness Benefits * Dental and Vision Plan Options * Short-term Disability ...

New

Allstate

Litigation Adjuster

New York, NY

We are seeking a Litigation Adjuster to handle attorneyrepresented claims with values up to $100 ... This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling ...

Allstate

OR · On-site

We are seeking a Litigation Adjuster to handle attorneyrepresented claims with values up to $100 ... This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling ...

AVONRISK

General Liability Adjuster

Los Angeles, CA · Remote

$55K - $95K/yr

General Liability Claims Adjuster MUST Reside in California & MUST have California General ... Competitive salary and benefits package, including medical, dental, vision, and 401(k)

Allstate

Litigation Adjuster

Concord, NC · On-site

We are seeking a Litigation Adjuster to handle attorneyrepresented claims with values up to $100 ... This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling ...

Manpower

Machine Adjuster Trainee

Mount Pleasant, PA

$21.98/hr

As a Machine Adjuster Trainee, you will be part of the Production Department supporting operational ... Medical and Prescription Drug Plans * Dental Plan * Supplemental Life Insurance * Short Term ...

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How much do medical adjuster jobs pay per year?

As of Jun 11, 2026, the average yearly pay for medical adjuster in the United States is $76,039.00, according to ZipRecruiter salary data. Most workers in this role earn between $66,000.00 and $85,500.00 per year, depending on experience, location, and employer.

How do I become a medical claims adjuster?

To become a medical claims adjuster, you typically need a high school diploma or equivalent, and some states require a license which involves completing pre-licensing courses and passing an exam. Relevant skills include attention to detail, knowledge of insurance policies, and familiarity with medical terminology; some employers prefer candidates with a background in healthcare or insurance. Continuing education and certification, such as the Certified Professional Coder (CPC) or other industry-specific credentials, can enhance job prospects.

What do medical adjusters do?

Medical adjusters evaluate insurance claims related to medical injuries or illnesses by reviewing medical records, consulting with healthcare providers, and determining claim validity and appropriate compensation. They often work with claims management software and require knowledge of medical terminology and insurance policies to make informed decisions.

What does a Medical Adjuster do?

A Medical Adjuster is responsible for evaluating insurance claims related to medical issues, injuries, or health treatments. They review medical records, assess the validity of claims, and determine the appropriate settlement amounts based on policy terms and medical evidence. Medical Adjusters often work closely with healthcare providers, claimants, and legal professionals to ensure claims are processed accurately and fairly. Their goal is to resolve claims efficiently while preventing fraud and controlling costs for insurance companies.

What are the key skills and qualifications needed to thrive as a Medical Adjuster, and why are they important?

To thrive as a Medical Adjuster, you need a strong understanding of medical terminology, insurance policies, and claims processing, often supported by a bachelor's degree or relevant experience. Familiarity with claims management software, ICD/CPT coding, and sometimes industry certifications like AIC (Associate in Claims) is important. Excellent analytical skills, attention to detail, and effective communication are essential soft skills for negotiating settlements and interacting with stakeholders. These skills ensure accurate claim evaluations, regulatory compliance, and efficient resolution of medical insurance claims.

What is the difference between Medical Adjuster vs Claims Examiner?

AspectMedical AdjusterClaims Examiner
Required CredentialsHigh school diploma or equivalent; certifications like AIC or CPCU beneficialHigh school diploma; often requires insurance licensing or certifications
Work EnvironmentInsurance companies, healthcare facilities, remote workInsurance companies, government agencies, remote or office-based
Job FocusAssessing medical claims, reviewing medical records, determining claim validityReviewing insurance claims for accuracy, compliance, and coverage

Medical Adjusters primarily evaluate medical claims and medical documentation to determine claim validity, often working closely with healthcare providers. Claims Examiners review insurance claims for accuracy and compliance, focusing on policy details. Both roles require attention to detail and knowledge of insurance processes, but Medical Adjusters have a stronger focus on medical information, while Claims Examiners handle broader claim review tasks.

What type of adjuster gets paid the most?

In the insurance industry, specialized adjusters such as catastrophe (cat) adjusters and complex claims adjusters tend to earn the highest salaries due to the complexity and urgency of their cases. These roles often require advanced knowledge, certifications, and the ability to handle large-scale or high-value claims, which are compensated accordingly.

What are some common challenges faced by Medical Adjusters when reviewing healthcare claims?

Medical Adjusters often encounter challenges such as interpreting complex medical records, keeping up with changing healthcare regulations, and balancing thoroughness with efficiency. They must carefully analyze claim details to identify discrepancies or potential fraud, all while communicating effectively with healthcare providers, patients, and insurance companies. Staying organized and up-to-date with medical terminology and industry standards is crucial for success in this role.

How much does a claims adjuster make?

A medical claims adjuster's average annual salary in Florida is approximately $55,000 to $70,000, depending on experience, certifications, and employer. Adjusters with specialized knowledge or certifications such as the AIC or CPCU may earn higher salaries, and the role often requires strong analytical skills and familiarity with claims processing software.
More about Medical Adjuster jobs
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What states have the most Medical Adjuster jobs? States with the most job openings for Medical Adjuster jobs include:
What job categories do people searching Medical Adjuster jobs look for? The top searched job categories for Medical Adjuster jobs are:
Medical Adjuster jobs near you

Workers Compensation Claims Adjuster I

AvonRisk

Rocklin, CA • Hybrid

$25 - $27/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

Job description

Description

AvonRisk is the nation's leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers' compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals and brands including Intercare, InterMed, George Hills, and AS&G Claims Administration, we're a people-focused, operations-driven organization that prioritizes reasonable caseloads, strong training, collaborative teams, and expert support. We invest in tools and workflows that reduce friction-not increase volume-and create real career paths for professionals who want to grow their careers or move into leadership. At AvonRisk, you're part of a team that values good judgment, curiosity, and accountability, and gives you the support to succeed.


Summary:

Under close supervision, analyzes insurance claims to determine extent of insurance carrier's liability and settles claims with claimants in accordance with policy provisions by performing the following duties.


Essential Duties and Responsibilities:

  • Three-point contact, initial investigation, initial benefit determination.
  • Ability to identify and address questionable (AOE/COE) claims.
  • Establish and monitor reserves at periodic intervals.
  • Prepare claims status report to carriers at 90-day intervals.
  • Ability to manage and direct medical care, including strategies to maintain medical control and objection when appropriate.
  • Identify and rate permanent disability. 
  • Vocational Rehabilitation file management
  • Negotiate and finalize claim settlements as well as lien settlements.
  • Identify and manage subrogation issues on workers' compensation claims.
  • Work independently and in a fast paced environment. 


Requirements

Competency:

To perform the job successfully, an individual should demonstrate the following competencies: 

  • Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics. 
  • Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. 
  • Interpersonal - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. 
  • Team Work - Supports everyone's efforts to succeed.

Qualification Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 


Education and/or Experience:

At least 1-3 years experience as a Workers' Compensation Claims Assistant, or up to one year Trainee or Future Med Adjuster experience; or Bachelor's degree (B.A.) and six months experience.


Salary Range:

$25-$27 per hour


The salary range listed is an estimate. Actual compensation will be determined based on several factors such as a candidate's experience, qualifications, skill set, and work location. 


Benefits

We take care of our people so they can take care of their work and their teams! AvonRisk offers a competitive, people first benefits package designed to support your health, financial security, and career growth, including:

  • Comprehensive medical, dental, and vision benefits
  • Company contributions to HSA and FSA plans
  • Employer paid life and disability insurance
  • 401(k) with company match
  • Paid time off (PTO) and company paid holidays
  • Learning and development opportunities that support real career advancement
  • Employee assistance resources and a supportive culture that values balance and wellbeing

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.


Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.


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