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Medical Claims Consultant Jobs (NOW HIRING)

Curi Holdings, Inc.

Claims Consultant

Midwest, WY · Remote

Title Claims Consultant Location Remote anywhere in the Midwest Region The Role We are looking for ... You will support and coordinate the defense of our insured physicians, hospitals, and/or medical ...

Poutrix

Principal Claims Consultant

Los Angeles, CA · On-site

$130 - $200/hr

Role description Arcadis seeks a Principal Claims Consultant with a broad and established ... These benefits include medical, dental, and vision, employee assistance program (EAP), 401(k) ...

Guardianlife

LTD Claims Consultant

$58K - $96K/yr

The LTD Claims Consultant will develop and maintain a culture of continuous improvement by ... Superior working knowledge of the financial, medical, occupational, and investigative aspects of ...

Guardian Life Insurance Company

LTD Claims Consultant

$58K - $96K/yr

The LTD Claims Consultant will develop and maintain a culture of continuous improvement by ... Superior working knowledge of the financial, medical, occupational, and investigative aspects of ...

HUB

Senior Claims Consultant

Tallahassee, FL · On-site

Medical/dental/visioninsurance and voluntary insurance options * Health Savings Account funding ... Consultation with clients on claims issues * Review and recommend solutions to coverage,quantumand ...

HUB

Senior Claims Consultant

Tampa, FL · On-site

Medical/dental/visioninsurance and voluntary insurance options * Health Savings Account funding ... Consultation with clients on claims issues * Review and recommend solutions to coverage,quantumand ...

HUB

Senior Claims Consultant

Jacksonville, FL

Medical/dental/visioninsurance and voluntary insurance options * Health Savings Account funding ... Consultation with clients on claims issues * Review and recommend solutions to coverage,quantumand ...

Arcadis

Principal Claims Consultant

Los Angeles, CA · On-site

$130K - $200K/yr

Role description: Arcadis seeks a Principal Claims Consultant with a broad and established ... These benefits include medical, dental, and vision, EAP, 401K, STD, LTD, AD&D, life insurance, paid ...

HUB

Senior Claims Consultant

Davie, FL · On-site

Medical/dental/visioninsurance and voluntary insurance options * Health Savings Account funding ... Consultation with clients on claims issues * Review and recommend solutions to coverage,quantumand ...

HUB

Senior Claims Consultant

Winter Park, FL

Medical/dental/visioninsurance and voluntary insurance options * Health Savings Account funding ... Consultation with clients on claims issues * Review and recommend solutions to coverage,quantumand ...

HUB

Senior Claims Consultant

Gainesville, FL

Medical/dental/visioninsurance and voluntary insurance options * Health Savings Account funding ... Consultation with clients on claims issues * Review and recommend solutions to coverage,quantumand ...

HUB

Senior Claims Consultant

Miami, FL · On-site

Medical/dental/visioninsurance and voluntary insurance options * Health Savings Account funding ... Consultation with clients on claims issues * Review and recommend solutions to coverage,quantumand ...

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Medical Claims Consultant information

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$14

$49

$79

How much do medical claims consultant jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for medical claims consultant in the United States is $49.12, according to ZipRecruiter salary data. Most workers in this role earn between $32.69 and $67.31 per hour, depending on experience, location, and employer.

What does a medical claims consultant do?

A Medical Claims Consultant is responsible for reviewing, analyzing, and processing medical insurance claims to ensure they comply with policy guidelines and legal requirements. They assess claims for accuracy, verify patient information, and determine the validity of claims submitted by healthcare providers or patients. Additionally, they may communicate with insurance companies, healthcare providers, and clients to resolve discrepancies or disputes. Their goal is to help ensure that claims are processed efficiently and fairly, minimizing errors and fraud. Medical Claims Consultants also provide guidance on billing practices and help streamline the claims process.

How does a medical claims consultant typically collaborate with healthcare providers and insurance companies to resolve claim issues?

Medical Claims Consultants act as intermediaries between healthcare providers and insurance companies, ensuring claims are processed accurately and efficiently. They regularly communicate with both parties to clarify documentation, resolve discrepancies, and negotiate settlements when necessary. This role often requires strong problem-solving skills and attention to detail, as consultants must interpret complex billing codes and insurance policies. Effective collaboration helps minimize claim denials and expedites reimbursements, contributing to smoother operations for all stakeholders.

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

To thrive as a Medical Claims Consultant, you need a strong understanding of medical terminology, insurance policies, and claims processing, often supported by a background in healthcare administration or insurance. Familiarity with claims management software, coding systems like ICD-10/CPT, and relevant certifications such as Certified Professional Coder (CPC) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for reviewing claims and interacting with providers and clients. These competencies are vital to ensure accurate claims adjudication, regulatory compliance, and efficient resolution of disputes, ultimately supporting both clients and insurers.

How to become a medical claims consultant?

To become a medical claims consultant, individuals typically need a bachelor's degree in health administration, insurance, or a related field. Gaining experience in healthcare billing, claims processing, or insurance claims is important, along with developing strong analytical and communication skills. Certifications such as the Certified Professional Coder (CPC) or Certified Claims Professional (CCP) can enhance job prospects.

Is claims processing a stressful job?

Medical Claims Consultants often find claims processing to be a demanding task due to strict deadlines, detailed documentation requirements, and the need for accuracy. The job can involve handling complex cases and communicating with healthcare providers and patients, which may contribute to stress levels, especially during high-volume periods or when resolving disputes. Developing strong organizational skills and familiarity with claims software can help manage workload effectively.
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What job categories do people searching Medical Claims Consultant jobs look for?

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

Medical Claims Consultant jobs near you
Infographic showing various Medical Claims Consultant job openings in the United States as of August 2026, with employment types broken down into 94% Full Time, and 6% Part Time. Highlights an 75% In-person, 6% Hybrid, and 19% Remote job distribution, with an average salary of $102,175 per year, or $49.1 per hour.

Claims Consultant

Curi Holdings, Inc.

Midwest, WY • Remote

Full-time

Posted 12 days ago

Job description

Title

Claims Consultant

Location

Remote anywhere in the Midwest Region

The Role

We are looking for a dynamic team player with strong communication skills to join our Claims team as a Claims Consultant, reporting to the Director of Claims. You will support and coordinate the defense of our insured physicians, hospitals, and/or medical providers. You will be responsible for investigating and managing claims-including, but not limited to, speaking with insureds and claimants; providing coverage analysis; assigning and working with defense counsel to ensure proper case management; establishing appropriate reserves; and negotiating resolution or issuing denials as appropriate.

Key Result Areas

  • Act as the first point of contact for insureds on general claim questions and claim reporting.
  • Perform coverage analysis and collaborate with Curi Legal team to prepare Reservation of Rights/declination letters when appropriate.
  • Work with defense counsel to develop the case, including expert support and case strategy.
  • Obtain expert reviews and conduct independent investigations when no defense counsel is assigned.
  • Maintain cases in a diary to ensure proper file management, evaluation, strategy, and timely reserve recommendations.
  • Keep current running notes to reflect file development and ensure proper data is maintained in the claims management system.
  • Negotiate claim settlements at mediation or directly with plaintiff counsel as indicated, or issue denials to claimant/claimant attorney as appropriate.
  • Attend first-suit meetings, mediations, and trials.
  • Attend and participate in Claims Review Committee meetings to provide strategy on claims file management.

Key Skills

  • Solid understanding of basic insurance concepts, including coverage, policy language, liability, negligence, and damages.
  • Strong organizational skills and ability to manage multiple tasks simultaneously.
  • Effective written and oral communication skills.
  • Ability to think critically and resolve problems of varying complexity.
  • Ability to perform with minimal supervision.
  • Self-motivated with a strong work ethic.
  • Excellent customer service skills.
  • Strong computer skills - experience with eOasis and OnBase is a plus.
  • Proficiency with Microsoft Office Suite.
  • Willingness to work flexible work hours depending on the physician's availability to meet with the Claims team.
  • Alignment with Curi's core values: accountability, curiosity, teamwork, inclusion, and service commitment. 

Travel

  • Up to 10% travel (some overnight) is anticipated for this position.

Key Qualifications

Required Education and Experience

  • Bachelor's degree with relevant claims, insurance, or legal experience will be considered.
  • Minimum of three years of claims experience (bodily injury claims experience a plus) and/or medical malpractice defense.
  • Must obtain applicable adjusters license(s) by state within three months of start date.

Preferred Education and Experience

  • Juris Doctor (JD) Preferred
  • Five years of medical malpractice claims and/or medical malpractice defense experience preferred.

Apply