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Medical Claims Assessor Jobs (NOW HIRING)

Corvel

Medical Only Claims Specialist

Overland Park, KS · Remote

$16.74 - $26.92/hr

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and ... down, based on assessment during interview process taking into consideration experience ...

Corvel

Medical Only Claims Specialist

Charlotte, NC · Remote

$16.74 - $26.92/hr

The Workers' Compensation Medical Only Claims Specialist manages non-complex and non-problematic ... down, based on assessment during interview process taking into consideration experience ...

Corvel

Indemnity Claims Specialist

Dallas, TX · Hybrid

$52K - $85K/yr

... down, based on assessment during interview process taking into consideration experience ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...

Corvel

Indemnity Claims Specialist

Dallas, TX · Hybrid

$52K - $85K/yr

... down, based on assessment during interview process taking into consideration experience ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...

Corvel

Indemnity Claims Specialist

Dallas, TX · Hybrid

$52K - $85K/yr

... down, based on assessment during interview process taking into consideration experience ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...

Broadway Ventures

Medical Claims Reviewer (RN)

OR · Remote

Assess payment determinations using clinical information and established guidelines. * Evaluate ... Educate internal and external teams on medical review processes, coverage determinations, and ...

Corvel

Indemnity Claims Specialist

Dallas, TX · On-site

$52K - $85K/yr

... down, based on assessment during interview process taking into consideration experience ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...

Corvel

Indemnity Claims Specialist

Dallas, TX · On-site

$52K - $85K/yr

... down, based on assessment during interview process taking into consideration experience ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...

Centivo

Claims Adjustor

Buffalo, NY · Remote

$19 - $23/hr

Health care providers treat patients, then file medical claims to receive payment from the patient's Benefit Plan. Claim Adjustors review and assess the claims, adjudicating payment to the provider ...

Corvel

New England Claims Specialist

$52K - $85K/yr

... down, based on assessment during interview process taking into consideration experience ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...

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Medical Claims Assessor information

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How much do medical claims assessor jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for medical claims assessor in the United States is $16.83, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $18.27 per hour, depending on experience, location, and employer.

What does a medical claims assessor do?

A Medical Claims Assessor reviews and evaluates insurance claims related to medical treatments and procedures. They assess the validity of claims by examining medical records, policy documents, and other relevant information to determine if the claim meets the policy’s terms and conditions. Their job is to ensure that legitimate claims are paid out efficiently while identifying and preventing fraudulent or ineligible claims. Medical Claims Assessors work closely with healthcare providers, insurance policyholders, and other professionals to resolve claims fairly and accurately.

What are some common challenges medical claims assessors face when evaluating claims, and how can they be managed?

Medical Claims Assessors often encounter challenges such as interpreting complex medical terminology, ensuring claims comply with policy terms, and detecting potential fraud. Managing these challenges requires strong attention to detail, ongoing training in medical coding and insurance regulations, and effective communication with healthcare providers. Collaborating with medical professionals and using specialized claims management software can streamline the assessment process and help maintain accuracy.

What are the key skills and qualifications needed to thrive as a medical claims assessor, and why are they important?

To thrive as a Medical Claims Assessor, you need a solid understanding of medical terminology, insurance policies, and claims processing, typically backed by a relevant diploma or experience in healthcare or insurance. Familiarity with claims management software, coding systems like ICD-10, and regulatory compliance tools is essential. Attention to detail, analytical thinking, and effective communication are critical soft skills for accurately evaluating claims and interacting with stakeholders. These skills ensure precise claim assessments, reduce errors, and maintain trust between insurers, healthcare providers, and clients.

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

AspectMedical Claims AssessorMedical Claims Processor
Required CredentialsRelevant certifications (e.g., insurance, healthcare)Similar certifications, often including insurance or healthcare knowledge
Work EnvironmentOffice-based, insurance companies, healthcare providersOffice or remote, insurance companies, healthcare organizations
Employer & Industry UsageInsurance firms, healthcare insurers, third-party administratorsInsurance companies, healthcare providers, third-party administrators
Common Search & ComparisonYesYes

The main difference between a Medical Claims Assessor and a Medical Claims Processor lies in their roles. Assessors evaluate claims for validity and coverage, often making decisions on approval or denial. Processors handle the administrative tasks of submitting, updating, and managing claims. Both roles require similar credentials and are found within insurance and healthcare sectors, but assessors focus on evaluation, while processors focus on administrative processing.

More about Medical Claims Assessor jobs
What states have the most Medical Claims Assessor jobs? States with the most job openings for Medical Claims Assessor jobs include:
What job categories do people searching Medical Claims Assessor jobs look for? The top searched job categories for Medical Claims Assessor jobs are:
Medical Claims Assessor jobs near you
Infographic showing various Medical Claims Assessor job openings in the United States as of August 2026, with employment types broken down into 91% Full Time, and 9% Contract. Highlights an 55% In-person, and 45% Remote job distribution, with an average salary of $35,000 per year, or $16.8 per hour.

Medical Only Claims Specialist

Corvel

Overland Park, KS • Remote

$16.74 - $26.92/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

CorVel rating

7.9

Company rating: 7.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

83rd of 150 rated financial services

Job description

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of the Claims Department and of CorVel. 

This is a remote role.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Receives claims, confirms policy coverage and acknowledgement of the claim
  • Determines the validity and compensability of the claim
  • Establishes reserves and authorizes payments within established reserving authority limits
  • Communicates claim status with the customer, claimant and client
  • Adheres to client and carrier guidelines and participates in claims review as needed
  • Assists other claims professionals with more complex or problematic claims as necessary
  • Additional duties as assigned

KNOWLEDGE & SKILLS:

  • Excellent customer service skills
  • Excellent written and verbal communication skills
  • Fast learner; develops knowledge and understanding of claims practice, relevant statutes, and medical terminology
  • Ability to identify, analyze and solve problems
  • Computer proficiency and technical aptitude to utilize Microsoft Office, including Excel spreadsheets
  • Strong interpersonal, time management, and organizational skills
  • Ability to work both independently and within a team environment

EDUCATION & EXPERIENCE:

  • Bachelor's degree or a combination of education and related experience
  • Minimum of 1 year industry experience and claim handling
  • WC experience required
  • Licensed as required jurisdictionally

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location.  Pay rates are established taking into account the following factors:  federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.  Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $16.74 - $26.92 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL:

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.   CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients.  We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.  Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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