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Medical Payments Adjuster Jobs (NOW HIRING)

CSAA

May handle 1st party medical payment and PIP claims. * Responsible for managing, investigating, and ... Must hold an Adjuster licensed for all applicable states or obtain license(s) within 90 days of ...

CSAA

May handle 1st party medical payment and PIP claims. * Responsible for managing, investigating, and ... Must hold an Adjuster licensed for all applicable states or obtain license(s) within 90 days of ...

CSAA

May handle 1st party medical payment and PIP claims. * Responsible for managing, investigating, and ... Must hold an Adjuster licensed for all applicable states or obtain license(s) within 90 days of ...

CSAA

May handle 1st party medical payment and PIP claims. * Responsible for managing, investigating, and ... Must hold an Adjuster licensed for all applicable states or obtain license(s) within 90 days of ...

CSAA

May handle 1st party medical payment and PIP claims. * Responsible for managing, investigating, and ... Must hold an Adjuster licensed for all applicable states or obtain license(s) within 90 days of ...

CSAA

May handle 1st party medical payment and PIP claims. * Responsible for managing, investigating, and ... Must hold an Adjuster licensed for all applicable states or obtain license(s) within 90 days of ...

CSAA

May handle 1st party medical payment and PIP claims. * Responsible for managing, investigating, and ... Must hold an Adjuster licensed for all applicable states or obtain license(s) within 90 days of ...

CSAA

May handle 1st party medical payment and PIP claims. * Responsible for managing, investigating, and ... Must hold an Adjuster licensed for all applicable states or obtain license(s) within 90 days of ...

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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 27, 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, candidates typically need a high school diploma or equivalent, along with relevant training or certification in insurance claims adjusting. Many employers prefer candidates with knowledge of medical terminology, insurance policies, and claims processing software. Licensing requirements vary by state and often involve passing an exam and completing continuing education courses.
More about Medical Payments Adjuster jobs

What cities are hiring for Medical Payments Adjuster jobs?

Cities with the most Medical Payments Adjuster job openings:

What states have the most Medical Payments Adjuster jobs?

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

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

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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, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $76,039 per year, or $36.6 per hour.

Florida Auto PIP / Medical Payments Adjuster

Miami, FL

UNIVISTA HOLDINGS LLC
See more jobs at UNIVISTA HOLDINGS LLCexternal

Full-time

Re-posted 29 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

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