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Medical Claims Adjudicator Jobs (NOW HIRING)

Naphcare, Inc.

Senior Claims Adjudicator

Birmingham, AL · On-site

Overview NaphCare is hiring an experienced Senior Claims Adjudicator just like you to join our team ... NaphCare is a family owned, medical technology company that has been delivering high quality health ...

NaphCare

Senior Claims Adjudicator

Vestavia Hills, AL · On-site

Overview NaphCare is hiring an experienced Senior Claims Adjudicator just like you to join our team ... NaphCare is a family owned, medical technology company that has been delivering high quality health ...

Senior TLC

Medical Claims Supervisor

Gastonia, NC · On-site

$65 - $90/hr

Minimum five years of experience in medical claims processing, claims adjudication, health plan operations, payer operations, or provider billing. Experience monitoring claims inventories, denied ...

Kintegra

Medical Claims Supervisor

Gastonia, NC · On-site

$70 - $90/hr

Minimum five years of experience in medical claims processing, claims adjudication, health plan operations, payer operations, or provider billing. Experience monitoring claims inventories, denied ...

Kintegra Health

Medical Claims Supervisor

Gastonia, NC · On-site

Minimum five years of experience in medical claims processing, claims adjudication, health plan operations, payer operations, or provider billing. Experience monitoring claims inventories, denied ...

Kintegra Health

Medical Claims Supervisor

Gastonia, NC · On-site

$65 - $90/hr

Minimum five years of experience in medical claims processing, claims adjudication, health plan operations, payer operations, or provider billing. Experience monitoring claims inventories, denied ...

Manulife

Bilingual Life Claims Adjudicator

Intermediate Claims Adjudicator And Administrator Manulife Insurance business unit is a leading ... Review claims and underwriting files for proper disclosure of past medical history, exclusions ...

NTT Data Americas, Inc.

Medical Claims Processor

$17 - $18/hr

... adjudicated as per clients defined workflows, guidelines • Sustaining and meeting the client ... s) of Medical Claims experience * 2+ year(s) using a computer with Windows applications that ...

ttg Talent Solutions

Medical Claims Processor

Doral, FL · On-site

$22 - $23/hr

Medical Claims Processor Location: Doral, FL on-site Schedule: Full-Time | 40 hours per week ... Experience with claims adjudication, reprocessing, disputes, appeals, and COB. * Familiarity with ...

Adecco

Medical Claims Examiner

San Antonio, TX · On-site

$22.50/hr

Key Requirements Recent medical claims experience REQUIRED Experience with medical claims adjudication Knowledge of Medicaid and Medicare guidelines Strong understanding of healthcare terminology and ...

Adecco

Medical Claims Examiner

San Antonio, TX · On-site

$22.50/hr

Hands-on experience with medical claims adjudication * Working knowledge of Medicaid and Medicare regulations * Strong understanding of healthcare terminology and claims workflows * Proven ability to ...

MedPOINT Management

Claims Examiner

Sherman Oaks, CA · Remote

$20 - $25/hr

... medical claims in accordance with plan benefits and company guidelines * Verify member eligibility, provider information, and coverage details prior to claims adjudication * Identify and resolve ...

Adecco

Medical Claims Examiner

San Antonio, TX

$22.50/hr

Hands-on experience with medical claims adjudication * Working knowledge of Medicaid and Medicare regulations * Strong understanding of healthcare terminology and claims workflows * Proven ability to ...

VIVA Health

Claims Training Coordinator

Birmingham, AL · Remote

Strong knowledge of medical claims adjudication processes, workflows, terminology, and benefit interpretation * Working knowledge of healthcare regulations and compliance requirements (CMS, HIPAA ...

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Medical Claims Adjudicator information

See salary details

$15

$26

$34

How much do medical claims adjudicator jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for medical claims adjudicator in the United States is $26.74, according to ZipRecruiter salary data. Most workers in this role earn between $22.60 and $30.29 per hour, depending on experience, location, and employer.

What is a medical claims adjudicator?

Medical Claims Adjudicators are professionals who review and process health insurance claims to determine if they are valid and eligible for payment. They analyze medical records, insurance policies, and billing codes to ensure claims comply with regulations and company guidelines. Their role is essential in preventing fraud and ensuring that healthcare providers and patients are reimbursed accurately and promptly.

What are the key skills and qualifications needed to thrive as a medical claims adjudicator?

To thrive as a Medical Claims Adjudicator, you need a strong understanding of medical terminology, health insurance policies, and claims processing, often supported by experience in healthcare administration or a related certification. Familiarity with claims management software, electronic health records (EHR) systems, and coding systems like ICD-10 and CPT is typically required. Attention to detail, analytical thinking, and effective communication are standout soft skills for this role. These skills ensure accurate and timely claims processing, minimize errors, and help maintain compliance with regulations, ultimately supporting both providers and patients.

What are some common challenges faced by medical claims adjudicators, and how can they be managed?

Medical Claims Adjudicators often encounter challenges such as interpreting complex medical documentation, ensuring compliance with ever-changing insurance policies, and managing a high volume of claims under tight deadlines. To manage these challenges, it is important to stay updated on policy guidelines, utilize available training resources, and communicate effectively with healthcare providers and team members. Strong organizational skills and attention to detail are essential for minimizing errors and ensuring claims are processed accurately and efficiently.

What is the difference between Medical Claims Adjudicator vs Medical Claims Processor?

AspectMedical Claims AdjudicatorMedical Claims Processor
CredentialsTypically requires a high school diploma or equivalent; certifications like CPC or CPC-A are commonUsually requires a high school diploma; certifications are less common
Work EnvironmentInsurance companies, healthcare providers, or third-party administratorsInsurance companies, healthcare providers, or billing offices
Job FocusReviewing, evaluating, and making decisions on claims based on policies and regulationsEntering and processing claim data for payment
Common Search IntentUnderstanding roles, responsibilities, and differencesProcessing claims efficiently and accurately

While both roles involve handling healthcare claims, Medical Claims Adjudicators focus on reviewing and making decisions on claims, ensuring compliance with policies. Medical Claims Processors primarily input and process claim data for payment. The adjudicator role often requires more analytical skills and decision-making authority, whereas processors focus on data entry and accuracy.

Is claims processing a stressful job?

Medical Claims Adjudicators often find claims processing to be a demanding task due to the need for accuracy, attention to detail, and adherence to strict guidelines. The job can involve repetitive work and tight deadlines, which may contribute to stress, but it also offers structured workflows and training to manage workload effectively.
More about Medical Claims Adjudicator jobs

What states have the most Medical Claims Adjudicator jobs?

States with the most job openings for Medical Claims Adjudicator jobs include:

What job categories do people searching Medical Claims Adjudicator jobs look for?

The top searched job categories for Medical Claims Adjudicator jobs are:

Medical Claims Adjudicator jobs near you
Infographic showing various Medical Claims Adjudicator job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $55,623 per year, or $26.7 per hour.

Senior Claims Adjudicator

Naphcare, Inc.

Birmingham, AL • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 15 days ago

Key responsibilities

  • Process claims for payment using claims processing experience and knowledge of Medicare and Medicaid while adhering to internal deadlines.

  • Handle daily workload with speed and accuracy, managing large volumes of data.

  • Act as a mentor for team members and perform additional duties and projects as assigned.

NaphCare rating

6.4

Company rating: 6.4 out of 10

Based on 49 frontline employees who took The Breakroom Quiz

648th of 898 rated healthcare providers

Job description

Overview

NaphCare is hiring an experienced Senior Claims Adjudicator just like you to join our team at our Corporate Office in Birmingham, AL This is an on-site position.  

NaphCare is a family owned, medical technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 36 years.  Come join our team of over 7000 employees and growing!  NaphCare pays well, offers outstanding benefits, and has an incredibly engaged corporate support team to make sure you have what you need to be truly excellent at what you do. 

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare.  We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need.  Be part of a world-class team of professionals who are revolutionizing correctional healthcare as you use our cutting-edge resources, including our award-winning electronic operating system.

NaphCare Benefits for Full-Time Employees Include:

  • Prescriptions free of charge through our health plan
  • Health, dental & vision insurance that starts day one!
  • Employment Assistance Program (EAP) services
  • 401K and Roth with company contribution that starts day one!
  • Tuition Assistance
  • Referral bonuses
  • On-site education
  • Free Continuing Education!
  • Term life insurance at no cost to the employee
  • Generous paid time off & paid holidays

NaphCare has a partnership with NetCE that provides CEU/CME for our staff. NetCE uses a rigorous peer review process to ensure that all activities and content are up to date. This service streamlines continuing education for all NaphCare Employees to meet state specific requirements for maintaining licensing.

With NaphCare, you'll play a critical role in our continuing mission to be the leading provider of quality healthcare in the correctional industry.  If you want a career that will make a difference, choose the company that is different.

We support your growth and internal promotion.  Once hired, we encourage our employees to continue to seek opportunities for advancement and leadership.


Responsibilities

Responsibilities for Senior Claim Adjudicator:

  • Utilize claims processing experience and working knowledge of Medicare and Medicaid to effectively and efficiently process claims for payment while adhering to internal deadlines.
  • Demonstrate ability to handle daily workload with speed and accuracy.
  • Demonstrate a high comfort level in working with large volumes of data.
  • Demonstrate the ability to act as a mentor for others within team.
  • Demonstrate a strong attention to detail and a commitment to customer service throughout the claims process.
  • Additional duties and specific projects as assigned.

Qualifications

Qualifications for Senior Claim Adjudicator:

  • Associate Degree or higher or equivalent work experience.
  • 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, and Medicare and Medicaid methodologies.
  • Proficiency in Microsoft Office Suite and strong written and verbal communication skills are also required.
  • CPC, COC, CIC, or Specialty Medical Coding Certification preferred.

If you would like to speak with our Talent Acquisition team to learn more about this position and NaphCare, please first apply directly to this position to initiate the application process, and then please send your resume to jerry.hughes@NaphCare.com where we will be in touch. 

Equal Opportunity Employer: disability/veteran

#NCE

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Workplace

Get the full story on Breakroom

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About NaphCare

Sourced by ZipRecruiter

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare. NaphCare offers competitive compensation! Our full-time teammates have a top-notch benefits package, which includes medical, dental, vision, FREE prescriptions, flexible spending account, company-paid life and AD&D insurance with voluntary life and AD&D options, ST & LT disability, 401(k) company contribution, 20 days Paid Time Off, paid holidays, tuition assistance, employee referral bonuses, etc.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Birmingham, AL, US

Year founded

1989

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