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Medical Claims Adjuster Jobs (NOW HIRING)

Orion180

Field Claims Adjuster

Houston, TX · On-site

Join our team as a Field Claims Adjuster in Houston TX! The Field Claims Adjuster is responsible ... Medical, dental, vision, 401k, paid holidays, PTO, and more. The office environment is fast-paced ...

AIG

Claims Adjuster, Warranty

Jeffersonville, IN · On-site

Join us as a Complex Claims Adjuster-Warranty to play your part in that transformation. It's an ... Competitive Medical, Dental and Vision insurance plans. * Opportunity to earn a performance-based ...

Snap-on Inc

Claims Adjuster II

Kenosha, WI · On-site

The Claims Adjuster II is responsible for adjusting claims from franchisee and corporate (Auto ... Review, document, and evaluate medical records and negotiate third party settlements with claimants ...

Snap-on Inc

Claims Adjuster II

Kenosha, WI · On-site

The Claims Adjuster II is responsible for adjusting claims from franchisee and corporate (Auto ... Review, document, and evaluate medical records and negotiate third party settlements with claimants ...

Orion180

Seasonal Claims Adjuster (Desk)

Melbourne, FL · On-site

Position Summary The Seasonal Claims Adjuster supports CITON's claims operations during periods of ... Evaluate repair estimates, medical records, wage documentation, and other supporting evidence to ...

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Medical Claims Adjuster information

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$30.5K

$64.6K

$90K

How much do medical claims adjuster jobs pay per year?

As of Sep 2, 2026, the average yearly pay for medical claims adjuster in the United States is $64,609.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,000.00 and $75,500.00 per year, depending on experience, location, and employer.

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

To thrive as a Medical Claims Adjuster, you need a strong understanding of medical terminology, insurance policies, and claims processing, often supported by relevant experience or a degree in a related field. Familiarity with claims management software, billing systems, and regulatory compliance tools is typically required. Analytical thinking, attention to detail, and effective communication are essential soft skills to excel in this role. These skills ensure accurate claim evaluations, minimize errors, and support fair and timely resolutions for policyholders and insurers.

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

Medical Claims Adjusters often encounter challenges such as navigating complex healthcare policies, managing large caseloads, and communicating with multiple stakeholders, including providers and policyholders. Staying organized and up-to-date on changing regulations is crucial. Effective adjusters develop strong analytical skills and leverage claims management software to streamline their workflow. Collaborating closely with other team members and seeking clarification from supervisors or legal experts also helps address difficult cases and ensure accurate claim resolutions.

What is the difference between Medical Claims Adjuster vs Medical Claims Examiner?

AspectMedical Claims AdjusterMedical Claims Examiner
CredentialsTypically requires insurance licensing and knowledge of claims processingOften requires similar insurance certifications and detailed medical billing knowledge
Work EnvironmentInsurance companies, third-party administrators, or healthcare organizationsInsurance companies, government agencies, or third-party payers
Job FocusInvestigating, evaluating, and settling insurance claimsReviewing and verifying medical claims for accuracy and compliance
Common Search IntentUnderstanding claims processing and settlementVerifying medical billing and claim accuracy

Both roles involve working with insurance claims, but Medical Claims Adjusters focus on settling claims and negotiating payouts, while Medical Claims Examiners verify the accuracy and compliance of medical claims. They often work in similar environments and require comparable certifications, making them closely related in the insurance and healthcare industries.

How to become a medical claims adjuster?

To become a medical claims adjuster, typically you need a high school diploma or equivalent, and some states require a license which involves passing a state exam. Relevant skills include knowledge of insurance policies, medical terminology, and claims processing software. Gaining experience through entry-level insurance or claims positions can also be beneficial.

Is it worth becoming a medical claims adjuster?

Medical claims adjusters evaluate insurance claims related to healthcare expenses, requiring knowledge of medical terminology and insurance policies. The role offers steady employment, typically with a standard schedule, and may require certification or training. It can be a stable career path for those interested in healthcare and insurance industries.

What does a medical claims adjuster do?

A medical claims adjuster reviews insurance claims related to healthcare services to determine coverage and appropriate payment. They analyze medical bills, verify policy details, and communicate with healthcare providers and policyholders to resolve claims efficiently, often using claims processing software. Strong attention to detail and knowledge of insurance policies are essential for this role.
More about Medical Claims Adjuster jobs

What cities are hiring for Medical Claims Adjuster jobs?

Cities with the most Medical Claims Adjuster job openings:

What states have the most Medical Claims Adjuster jobs?

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

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

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

Medical Claims Adjuster jobs near you
Infographic showing various Medical Claims Adjuster 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 $64,609 per year, or $31.1 per hour.

Claims Adjuster - Workers Compensation - Remote / Telecommute

Cynet Systems

El Dorado Hills, CA • On-site

$32.85 - $37.85/hr

Other

Medical, Dental, Vision, Life, Retirement

Posted yesterday

New

Job description

We are looking for Claims Adjuster - Workers Compensation - Remote / Telecommute for our client in El Dorado Hills CA.

Job Title: Claims Adjuster - Workers Compensation - Remote / Telecommute

Job Location: El Dorado Hills CA

Job Type: Contract

Job Overview:

Pay Range: $32.85hr - $37.85hr

Requirement/Must Have:

  • Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business.
  • PC literate, including Microsoft Office products.
  • Analytical and interpretive skills.
  • Strong organizational skill.
  • Excellent negotiation skills.
  • Ability to work in a team environment.
  • Ability to meet or exceed Service Expectations.

Responsibilities:

  • Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
  • Develops and manages workers compensation claims action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
  • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
  • Manages subrogation of claims and negotiates settlements.
  • Communicates claim action with claimant and client.
  • Ensures claim files are properly documented and claims coding is correct.
  • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
  • Maintains professional client relationships.
  • Performs other duties as assigned.
  • Supports the organization s quality program(s).

Skills:

  • Workers Compensation Claims Adjudication.
  • Subrogation Negotiation.
  • Settlement Negotiation.
  • Microsoft Office.
  • Strong verbal and written communication skills.
  • Excellent communication and presentation skills.
  • Good interpersonal skills.

Qualification And Education:

  • Bachelor s degree from an accredited college or university preferred.
Benefits
Our Benefits Include:
  • Medical, Dental, and Vision Insurance
  • 401(k) Retirement Plan
  • Health Savings Account (HSA)
  • Disability Insurance (Short-Term and Long-Term)
  • Life and AD&D Insurance
  • Paid Sick Leave (where required by applicable state or local law)
  • Supplemental Insurance Plans
  • Identity Theft Protection
  • Pet Insurance
  • Employee Wellness Programs
  • Employee Assistance Program (EAP)
  • Career Growth and Professional Development Opportunities
Disclaimer: Benefits eligibility, accrual rates, and usage limits may vary based on employment status, length of service, and work location. Paid Sick Leave is provided in strict accordance with applicable state and municipal mandates. Cynet Systems Inc. reserves the right to modify, amend, or terminate any benefit plans at any time in accordance with applicable laws.

About Cynet Systems

Founded in 2010 and headquartered in the Washington, DC metro area, Cynet Systems Inc. is a leading technology staffing and workforce solutions company serving Fortune 500 companies, government agencies, and enterprise organizations across the United States and Canada. We deliver agile, scalable talent solutions across IT, engineering, life sciences, clinical, and professional staffing, powered by a high-performing recruitment engine operating across North America and Asia.
As a nationally and locally certified Minority Business Enterprise (MBE), Cynet Systems is committed to helping organizations build high-performing teams while empowering professionals to grow rewarding careers. Our organization is certified to ISO 9001, ISO 14001, ISO 27001, and SOC 2 Type II standards, reflecting our commitment to quality, security, operational excellence, and customer success.
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About Cynet Systems

Sourced by ZipRecruiter

Cynet Systems Inc is a staffing and recruiting corporation nestled in Ashburn, VA, USA. Established in 2010, the company operates within the Information Technology and Services sector, specializing in providing effective workforce solutions to different business needs, including IT consulting, direct hire, and contract staffing services. Through the years, Cynet Systems has built an impressive portfolio, going beyond borders and expanding its operations internationally in Canada and India. Rooted in its core values of teamwork, leadership, and commitment, Cynet Systems helps businesses unlock their full potential by providing versatile and competent professionals that perfectly align with their needs. Fueled by their unwavering mission to deliver top-tier talent to businesses worldwide, Cynet Systems garnered various recognitions including SIA's fastest-growing staffing firms and Best Place to Work in Virginia for 2019.

Industry

It services

Company size

501 - 1,000 Employees

Headquarters location

Sterling, VA, US

Year founded

2010

Social media

Twitter

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