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Medical Claim Adjuster Jobs (NOW HIRING)

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 ...

FCCI Insurance Group

Medical Claim Adjuster

Glen Allen, VA · Hybrid

$22.54 - $34.72/hr

We are seeking a detail-oriented and analytical Medical Claim Adjuster to investigate, evaluate, and manage assigned workers' compensation medical-only claims. In this role, you will determine ...

FCCI Insurance Group

Medical Claim Adjuster

Ridgeland, MS · Hybrid

$22.54 - $34.72/hr

We are seeking a detail-oriented and analytical Medical Claim Adjuster to investigate, evaluate, and manage assigned workers' compensation medical-only claims. In this role, you will determine ...

FCCI Insurance Group

Medical Claim Adjuster

Lake Mary, FL · Hybrid

$22.54 - $34.72/hr

We are seeking a detail-oriented and analytical Medical Claim Adjuster to investigate, evaluate, and manage assigned workers' compensation medical-only claims. In this role, you will determine ...

FCCI Insurance Group

Medical Claim Adjuster

Sarasota, FL · Hybrid

$22.54 - $34.72/hr

We are seeking a detail-oriented and analytical Medical Claim Adjuster to investigate, evaluate, and manage assigned workers' compensation medical-only claims. In this role, you will determine ...

FCCI Insurance Group

Medical Claim Adjuster

Sarasota, FL · On-site

$22.54 - $34.72/hr

We are seeking a detail-oriented and analytical Medical Claim Adjuster to investigate, evaluate, and manage assigned workers' compensation medical-only claims. In this role, you will determine ...

Chubb

Claim Adjuster

Chattanooga, TN · On-site

$65K/yr

The Claims Adjuster is responsible for contacting claimant and /or service providers to request ... Knowledge of medical terminology The pay range for the role is $ 40,500 to $65,900. The specific ...

New

Chubb

Claim Adjuster

Chattanooga, TN

$48K - $67K/yr

The Claims Adjuster is responsible for contacting claimant and /or service providers to request ... Knowledge of medical terminology The pay range for the role is $48,000 to $67,000. The specific ...

New

CCMSI

Workers' Compensation Claim Adjuster

Wall, NJ

$70K - $90K/yr

Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices ... adjusters stand out through ownership, accuracy, and impact. We measure success by: * Quality claim ...

CCMSI

Workers' Compensation Claim Adjuster

Wall, NJ

$68K - $88K/yr

Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices ... adjusters stand out through ownership, accuracy, and impact. We measure success by: * Quality claim ...

CCMSI

Workers' Compensation Claim Adjuster

Wall, NJ · On-site

$83K - $90K/yr

Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices ... adjusters stand out through ownership, accuracy, and impact. We measure success by: * Quality claim ...

CCMSI

Workers' Compensation Claim Adjuster

Wall, NJ

$83K - $90K/yr

Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices ... adjusters stand out through ownership, accuracy, and impact. We measure success by: * Quality claim ...

CCMSI

Workers' Compensation Claim Adjuster

Wall, NJ

$68K - $88K/yr

Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices ... adjusters stand out through ownership, accuracy, and impact. We measure success by: * Quality claim ...

CCMSI

Workers' Compensation Claim Adjuster

Wall, NJ · On-site

$70K - $90K/yr

Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices ... adjusters stand out through ownership, accuracy, and impact. We measure success by: * Quality claim ...

FCCI Insurance Group

E&S Claim Adjuster

Lawrenceville, GA · On-site +1

$91K - $140K/yr

We are currently seeking an E&S Claim Adjuster to investigate and adjust assigned Excess and ... Medical, Vision, Dental & Life Insurance * Employee Referral Bonus * Paid Volunteer Time * 401(k) ...

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Medical Claim Adjuster information

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$41K

$76K

$99K

How much do medical claim adjuster jobs pay per year?

As of Jul 17, 2026, the average yearly pay for medical claim 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.

What are some common challenges faced by Medical Claim Adjusters, and how can they be managed effectively?

Medical Claim Adjusters often encounter challenges such as interpreting complex medical records, navigating evolving insurance policies, and communicating effectively with healthcare providers and claimants. Staying updated on industry regulations and utilizing claim management software can help manage these complexities. Additionally, strong organizational skills and ongoing professional development are key to balancing a high volume of cases and delivering accurate, timely decisions.

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

To thrive as a Medical Claim Adjuster, you need a solid understanding of medical terminology, insurance policies, and claims processing, often supported by a background in healthcare administration or insurance. Familiarity with claims management software, ICD and CPT coding systems, and sometimes state licensure or industry certifications is typically required. Strong analytical skills, attention to detail, and effective communication are crucial soft skills for reviewing claims and interacting with policyholders or healthcare providers. These competencies ensure accurate claim evaluations, minimize errors or fraud, and facilitate fair and timely resolutions.

What does a Medical Claim Adjuster do?

A Medical Claim Adjuster reviews and evaluates insurance claims related to medical treatments and healthcare services. They assess the validity of claims, determine the amount payable under an insurance policy, and ensure claims are processed accurately and fairly. Their work involves investigating the details of each claim, communicating with healthcare providers and policyholders, and adhering to legal and company guidelines. Medical Claim Adjusters play a crucial role in preventing fraud and ensuring that claims are settled efficiently.

What is the difference between Medical Claim Adjuster vs Medical Claims Processor?

AspectMedical Claim AdjusterMedical Claims Processor
CredentialsInsurance licenses, certifications (e.g., CPC, CPC-A)None typically required, basic computer skills
Work EnvironmentInsurance companies, healthcare providers, remote or officeHealthcare offices, insurance companies, remote options
Job ResponsibilitiesReview, investigate, and approve or deny claimsEnter, process, and track claim data
Industry UsageCommonly used in insurance and healthcare sectorsUsed in insurance and healthcare settings

The main difference is that Medical Claim Adjusters evaluate and decide on claims, often requiring certifications, while Medical Claims Processors handle data entry and processing tasks. Both roles are essential in the claims workflow but differ in responsibilities and credentials.

More about Medical Claim Adjuster jobs
What cities are hiring for Medical Claim Adjuster jobs? Cities with the most Medical Claim Adjuster job openings:
What states have the most Medical Claim Adjuster jobs? States with the most job openings for Medical Claim Adjuster jobs include:
What job categories do people searching Medical Claim Adjuster jobs look for? The top searched job categories for Medical Claim Adjuster jobs are:
Medical Claim Adjuster jobs near you
Medical Claim Adjuster

Medical Claim Adjuster

Larkin Community Hospital

Miami, FL • On-site

$63K - $81K/yr

Full-time

Re-posted 25 days ago

Job description

JOB TITLE: 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 locations in South Miami, Hialeah and Hollywood, Florida. Our network of acute care hospitals provide a complete continuum of healthcare services, including a full range of inpatient and outpatient services, and home health agencies in Miami-Dade and Broward County. We are heavily invested in training the next generation of health professionals, which is the core of our mission: to provide access to compassionate care of the highest quality in an educational environment.

GENERAL JOB DESCRIPTION

Under the direction of the Business Office Director, the Medical Claim Adjuster is responsible for reviewing and adjusting accounts in accordance with claims processing guidelines.

DUTIES AND RESPONSIBILITIES

  • Perform adjustments using technical and claims processing expertise.
  • Identify discrepancies in payments, adjust accounts based on expected amount.
  • Review and interpret contract language using provider contracts to confirm whether a claim is overpaid or underpaid.
  • Review denials and ensures posting reflects the appropriate denial reason code.
  • Review and handle relevant correspondences assigned to the team that may result in adjustments to accounts.
  • Preforms related duties as required.

QUALIFICATIONS FOR THE JOB

Education:

High School diploma of equivalent (additional certifications or education in medical billing/coding preferred)

Experience:

  • 1-2+ year’s claims processing experience.

Other:

  • Strong understanding of medical terminology, CPT codes, ICD-10 codes, and insurance billing guidelines.
  • Excellent numerical and analytical skills, with a keen eye to detail.
  • Ability to interpret insurance EOBs and payment information accurately.
  • Strong problem-solving skills, with the ability to reconcile discrepancies and resolve payment-related issues effectively.
Larkin Community Hospital logo

About Larkin Community Hospital

Sourced by ZipRecruiter

At Larkin, we have been serving the health care needs of South Miami, Hialeah, and the surrounding communities for more than 40 years. We take pride in the continuing tradition of caring. We remain dedicated to providing excellent medical care with the personal touch and convenience that only a community hospital offers.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

South Miami, FL, US

Year founded

1969

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