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Medical Payments Adjuster Jobs (NOW HIRING)

UNIVISTA HOLDINGS LLC

$17.25 - $23/hr

Florida Auto PIP / Medical Payments Adjuster We are seeking a detail-oriented and experienced Florida Auto PIP / Medical Payments Adjuster to join our claims team. This position is responsible for ...

Brookfield

TEMP-Workers' Compensation Claims Adjuster

Omaha, NE · On-site +1

$63K - $81K/yr

... medical payments are made timely and accurately. The position emphasizes strong claim management ... Our Adjusters contribute to providing superb results for our clients. Although Rockwood underwrites ...

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Medical Payments Adjuster information

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$76K

$99K

How much do medical payments adjuster jobs pay per year?

As of Aug 16, 2026, the average yearly pay for medical payments adjuster in the United States is $76,039.00, according to ZipRecruiter salary data. Most workers in this role earn between $66,000.00 and $85,500.00 per year, depending on experience, location, and employer.

What does a medical payments adjuster do?

A Medical Payments Adjuster is responsible for reviewing and processing insurance claims related to medical expenses after an accident or injury. They examine policy details, verify the validity of the claim, assess medical documentation, and determine the appropriate payment based on coverage limits. Their goal is to ensure that claims are handled fairly, efficiently, and according to the terms of the insurance policy while preventing fraud.

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

To thrive as a Medical Payments Adjuster, strong analytical skills, attention to detail, and a solid understanding of insurance policies and medical terminology are essential, often supported by a bachelor's degree or relevant claims experience. Familiarity with claims management software, billing codes, and regulatory compliance tools is typically required. Excellent communication, negotiation, and empathy help navigate interactions with claimants, providers, and internal teams. These skills ensure accurate claim assessments, cost control, and customer satisfaction in a high-stakes, deadline-driven environment.

What are some common challenges faced by medical payments adjusters, and how can new hires prepare for them?

Medical Payments Adjusters often encounter challenges such as handling a high volume of complex claims, interpreting medical documentation, and communicating with various stakeholders like healthcare providers, claimants, and legal representatives. New hires can prepare by developing strong organizational skills, becoming familiar with medical terminology, and practicing effective communication. Additionally, staying up-to-date on insurance regulations and company procedures will help ensure efficient and accurate claim processing.

What is the difference between Medical Payments Adjuster vs Claims Processor?

AspectMedical Payments AdjusterClaims Processor
Required CredentialsHigh school diploma; certifications like CPCU or ARM beneficialHigh school diploma; often some insurance or claims processing training
Work EnvironmentInsurance companies, healthcare providers, or third-party administratorsInsurance companies, claims centers, or third-party administrators
Job FocusReviewing and adjusting medical payment claims, verifying coverage, negotiating settlementsProcessing insurance claims, data entry, verifying claim information

Medical Payments Adjusters and Claims Processors both work within insurance environments, but Medical Payments Adjusters focus on evaluating and settling medical payment claims, often requiring specific certifications. Claims Processors handle the initial processing of claims, with less emphasis on negotiations. Understanding these differences helps job seekers identify the right role based on their skills and career goals.

How to become a medical payments adjuster?

To become a medical payments adjuster, typically one needs a high school diploma or equivalent, along with knowledge of insurance claims and medical terminology. Many employers prefer candidates with prior experience in insurance adjusting or related fields, and obtaining relevant certifications such as the Certified Professional Coder (CPC) or insurance adjuster licenses can improve job prospects. On-the-job training is common, and strong communication and analytical skills are essential for success in this role.
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What states have the most Medical Payments Adjuster jobs?

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Medical Payments Adjuster jobs near you
Infographic showing various Medical Payments 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 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $76,039 per year, or $36.6 per hour.

Florida Auto PIP / Medical Payments Adjuster

UNIVISTA HOLDINGS LLC

$17.25 - $23/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 18 days ago

Job description

Florida Auto PIP / Medical Payments Adjuster

We are seeking a detail-oriented and experienced Florida Auto PIP / Medical Payments Adjuster to join our claims team. This position is responsible for handling Personal Injury Protection (PIP) and Medical Payments claims in accordance with Florida statutes, policy provisions, Medicaid and Medicare fee schedule and company guidelines. The ideal candidate will have strong knowledge of Florida PIP regulations, and the ability to manage claims efficiently while providing excellent service to insureds and medical providers.

Key Responsibilities:

  • Review medical bills, records, and documentation for accuracy and compliance
  • Apply Florida PIP statutes and fee schedules to determine appropriate payments
  • Communicate with insureds, claimants, attorneys, and medical providers
  • Good faith settlements/negotiations with provides offices
  • Document claim activity and maintain accurate claim files
  • Issue payments and explanations of benefits (EOBs) as appropriate
  • Identify potential fraud indicators and escalate when necessary
  • Maintain compliance with company procedures and regulatory requirements
  • Manage claim workload to meet productivity and quality standards

Qualifications:

  • Some Florida PIP or Medical Payments claims handling experience
  • Some knowledge of Florida PIP statutes and fee schedules
  • Experience reviewing medical bills and medical documentation
  • Excellent organizational and time management skills
  • Strong bilingual written and verbal communication skills
  • Ability to work independently and manage a high-volume caseload
  • Claims system experience preferred

Preferred:

  • Florida Adjuster License (620 or equivalent)
  • Experience with medical payments, excel and/or medical coding

ABOUT US

We are a fast-growing, bilingual insurance agency serving clients across Florida and Texas! Our team helps families and businesses protect what matters most — through auto, home, life, and commercial insurance solutions built around each client’s needs.

We are not your average insurance agency. We invest in our people, recognize performance, and create real paths for growth — from your first day in the office to owning your own location. If you are bilingual, driven, and want a career that rewards your work, you have found the right team.

  WHY JOIN US

We know talented bilingual insurance professionals have options. Here is what makes us different:

  Real base pay  —  Competitive salary based on experience and license held

  Paid Time Off  —  1 week PTO to start, growing with tenure

  Medical Insurance  —  Comprehensive health coverage for you

  Sick Time  —  Dedicated sick time separate from your PTO

  Dental & Vision  —  Comprehensive dental and vision coverage

  Performance Bonus  —  Structured plan tied directly to your results

  Supplemental Plans  —  Voluntary supplemental options available

  Employee Referral  —  Earn rewards for bringing great talent in

  Basic Life Insurance  —  Company-paid life insurance

  Career Growth Path  —  CSR → Agent → Team Lead → Manager → Owner

  401(k) with Match  —  Invest in your retirement savings with us!

  Training & Development  —  Ongoing sales, product, customer service & compliance training

  OUR CORE VALUES

“The harder we work, the luckier we are.”

PROTECT

Safety for our communities

We ensure the safety of our communities by offering robust insurance options for life’s many facets. Quality and comprehensiveness are the hallmarks of our coverage.

HELP

Swift, personalized support

Our agents are ready to assist with any insurance questions, providing swift and personalized support to guide clients through their options.

PROMOTE

Investing in our workforce

We invest in the future of our workforce with career paths and training for aspiring agents, contributing to the growth of the insurance sector.

BUILD

Trust & transparency

Our client relationships are built on trust and transparency, with each interaction tailored to meet individual insurance needs.

EDUCATE & GUIDE

Clarity & empowerment

Clarity and empowerment are the goals of our resources, aimed at helping clients make informed insurance decisions.

PROVIDE

Accessible solutions

We deliver affordable and innovative insurance solutions made readily accessible through tools like our app, enhancing convenience for our clients.

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