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Medical Claims Officer Jobs (NOW HIRING)

SVP, Chief Claims Officer

Doral, FL ยท On-site

$250K - $350K/yr

... Chief Claims Officer Position Summary Responsible for the strategic leadership, operational ... This job is eligible for an annual discretionary bonus, equity, and Kemper benefits (Medical ...

SVP, Chief Claims Officer

Birmingham, AL ยท On-site

$250K - $350K/yr

... Chief Claims Officer Position Summary Responsible for the strategic leadership, operational ... This job is eligible for an annual discretionary bonus, equity, and Kemper benefits (Medical ...

SVP, Chief Claims Officer

Downers Grove, IL ยท On-site

$250K - $350K/yr

... Chief Claims Officer Position Summary Responsible for the strategic leadership, operational ... This job is eligible for an annual discretionary bonus, equity, and Kemper benefits (Medical ...

SVP, Chief Claims Officer

Lake Mary, FL ยท On-site

$250K - $350K/yr

... Chief Claims Officer Position Summary Responsible for the strategic leadership, operational ... This job is eligible for an annual discretionary bonus, equity, and Kemper benefits (Medical ...

SVP, Chief Claims Officer

Miami, FL ยท On-site

$250K - $350K/yr

... Chief Claims Officer Position Summary Responsible for the strategic leadership, operational ... This job is eligible for an annual discretionary bonus, equity, and Kemper benefits (Medical ...

SVP, Chief Claims Officer

Richardson, TX ยท On-site

$250K - $350K/yr

... Chief Claims Officer Position Summary Responsible for the strategic leadership, operational ... This job is eligible for an annual discretionary bonus, equity, and Kemper benefits (Medical ...

SVP, Chief Claims Officer

Henderson, NV ยท On-site

$250K - $350K/yr

... Chief Claims Officer Position Summary Responsible for the strategic leadership, operational ... This job is eligible for an annual discretionary bonus, equity, and Kemper benefits (Medical ...

SVP, Chief Claims Officer

Cerritos, CA ยท On-site

$250K - $350K/yr

... Chief Claims Officer Position Summary Responsible for the strategic leadership, operational ... This job is eligible for an annual discretionary bonus, equity, and Kemper benefits (Medical ...

AVP, Claims-TCO

Morristown, NJ ยท On-site

$145K - $198K/yr

Position Summary Reporting to the Chief Technical Claim Officer (CTCO), this role is a ... that includes multiple medical plans plus dental, vision and prescription drug coverage; a ...

AVP, Claims-TCO

Morristown, NJ ยท Hybrid

$145K - $198K/yr

Position Summary Reporting to the Chief Technical Claim Officer (CTCO), this role is a ... that includes multiple medical plans plus dental, vision and prescription drug coverage; a ...

AVP, Claims-TCO

Morristown, NJ ยท Hybrid

$145K - $198K/yr

Position Summary Reporting to the Chief Technical Claim Officer (CTCO), this role is a ... that includes multiple medical plans plus dental, vision and prescription drug coverage; a ...

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Medical Claims Officer information

See salary details

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$16

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How much do medical claims officer jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for medical claims officer 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 are some common challenges medical claims officers face when processing claims, and how can they be managed?

Medical Claims Officers often encounter challenges such as incomplete documentation, discrepancies in patient information, and the need to interpret complex medical codes. Managing these issues typically requires strong attention to detail, effective communication with healthcare providers, and up-to-date knowledge of insurance policies and regulations. Many organizations support their Claims Officers through ongoing training and by fostering collaboration with medical and administrative teams to resolve issues quickly and accurately.

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

To thrive as a Medical Claims Officer, you need strong knowledge of healthcare insurance policies, medical terminology, and claims processing, usually supported by a degree in healthcare administration or a related field. Familiarity with claims management systems, medical billing software, and regulatory compliance tools is essential. Attention to detail, analytical thinking, and effective communication are crucial soft skills for evaluating claims and collaborating with providers and policyholders. These abilities ensure accurate claims adjudication, minimize errors or fraud, and support positive relationships with clients and healthcare partners.

What is the difference between Medical Claims Officer vs Medical Billing Specialist?

AspectMedical Claims OfficerMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies, claims processing, and relevant certificationsRequires understanding of billing codes, insurance procedures, and often similar certifications
Work EnvironmentHealthcare facilities, insurance companies, or third-party claims processorsMedical offices, clinics, or billing companies
Employer & Industry UsageUsed in healthcare and insurance sectors for claims processing rolesCommon in healthcare settings for billing and coding tasks
Search & Comparison IntentOften compared for claims processing and reimbursement rolesCompared for billing, coding, and revenue cycle management

The Medical Claims Officer and Medical Billing Specialist roles share similarities in certifications and work environments but differ mainly in their focus. The Claims Officer handles the processing and approval of insurance claims, while the Billing Specialist manages billing procedures and coding. Both roles are essential in healthcare revenue cycle management, but they serve distinct functions within the industry.

What is a medical claims officer?

Medical Claims Officers are professionals responsible for reviewing, processing, and assessing medical insurance claims submitted by patients or healthcare providers. They ensure that claims are accurate, meet policy requirements, and are supported by the necessary documentation. Their work involves investigating claims, communicating with clients and healthcare providers, and authorizing payments or denying claims as appropriate. Medical Claims Officers play a key role in preventing insurance fraud and ensuring the fair handling of claims.
More about Medical Claims Officer jobs
Infographic showing various Medical Claims Officer job openings in the United States as of July 2026, with employment types broken down into 90% Full Time, 8% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $35,000 per year, or $16.8 per hour.

SVP, Chief Claims Officer

Kemper

Doral, FL โ€ข On-site

$250K - $350K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 12 days ago


Job description

Location(s)

Birmingham, Alabama, Cerritos, California, Doral, Florida, Downers Grove, Illinois, Henderson, Nevada, Lake Mary, Florida, Miami, Florida, Richardson, Texas

Details

SVP, Chief Claims Officer

Position Summary

Responsible for the strategic leadership, operational excellence, and financial performance of the P&C Claims organization. Oversees all aspects of claims handling for the specialty auto business, including liability, physical damage, litigation, SIU (Special Investigations Unit), and vendor management, with a strong emphasis on managing severity, controlling loss costs, and delivering fair, timely outcomes for policyholders.

The CCO plays a critical role in shaping claims philosophy for complex and high-risk auto segments, balancing customer experience, regulatory compliance, and profitability.

Key Responsibilities

  • Develop and execute the overall claims strategy aligned with corporate objectives, underwriting appetite, and growth goals in specialty auto segments. Establish claims best practices tailored to non-standard and specialty risks, including high-frequency/low-severity and complex liability exposures.

  • Partner with underwriting, actuarial, and product teams to provide insights on loss trends, claims severity, and emerging risks (e.g., litigation trends, fraud patterns, social inflation).

  • Lead end-to-end claims operations, including FNOL (First Notice of Loss), adjudication, subrogation, litigation management, and salvage. Drives continuous improvement in claims cycle time, accuracy, indemnity leakage, and expense management.

  • Implement advanced analytics and automation to enhance claims decision-making and efficiency.

  • Own claims P&L performance, including loss ratios, LAE (Loss Adjustment Expense), and reserving accuracy.

  • Collaborate with actuarial teams on reserving methodologies and ensure adequacy of case reserves.

  • Manage vendor relationships (TPAs, independent adjusters, legal counsel, repair networks) to optimize cost and performance.

  • Develop strategies to manage complex and litigated claims, including bodily injury and attorney-represented cases.

  • Lead anti-fraud strategy, including detection, investigation, and prevention of organized fraud rings and opportunistic fraud.

  • Ensure strong SIU capabilities aligned with regulatory requirements.

  • Ensure compliance with all state regulatory requirements, including claims handling standards and reporting obligations. Maintain strong internal controls and audit readiness. Engage with regulators, industry groups, and external stakeholders as needed.

  • Build and lead a high-performing claims organization, including recruitment, development, and retention of top talent. Foster a culture of accountability, continuous learning, and ethical decision-making. Develop leadership bench strength and succession plans.

Qualifications

  • Bachelor's degree required; advanced degree (MBA, JD) preferred. Professional designations (CPCU, AIC, ARM) strongly preferred.

  • Ability to work in a hybrid environment from one of our Claims office locations.

Experience

  • At least 15 years claims leadership experience in auto insurance, with significant exposure to specialty or non-standard segments.

  • Proven track record managing large-scale claims operations and delivering improved loss ratios and operational efficiency.

  • Deep expertise in bodily injury, litigation management, and claims analytics.

The base range for this position is $250,000 to $350,000. When determining candidate offers, we consider experience, skills, education, certifications, and geographic location among other factors. This job is eligible for an annual discretionary bonus, equity, and Kemper benefits (Medical, Dental, Vision, PTO, 401k, etc.)

Kemper is proud to be an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, disability status or any other status protected by the laws or regulations in the locations where we operate. We are committed to supporting diversity and equality across our organization and we work diligently to maintain a workplace free from discrimination. Kemper is focused on expanding our Diversity, Equity and Inclusion efforts to align with our vision, mission, and guiding principles.

Kemper does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Kemper and Kemper will not be obligated to pay a placement fee.

Kemper will never request personal information, such as your social security number or banking information, via text or email. Additionally, Kemper does not use external messaging applications like WireApp or Skype to communicate with candidates. If you receive such a message, delete it.

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