279 Results for

Claims Examiner Jobs in the United States

Jobs

Lombard, IL10 days ago

$25–$25 Per Hour
Full-time
Employee

Calculate multiple benefits due based a combination of information on claim forms, medical information, plan certificates/contract and regulatory guidelines and administer provisions accurately, including, but not limited to, misrepresentation or pre-existing Investigation, Evidence of Insurability Review, Benefit Entitlement Review, Financial Accuracy, ERISA Guidelines, MAR Requirements, State Regulations, Company Financial Liability as applicable. Responsible for examining and processing all claim types including Accident Insurance, Critical Illness/Specified Disease, Hospital Indemnity Life product claims and weekly income claims in accordance with established policies and procedures.

New!

New Haven, CT4 days ago

Claim Examiner position with prior experience in workers’ compensation as a claim examiner, or commensurate examiner experience in paralegal, short-term / long-term disability, auto personal injury protection / medical injury, general liability, medical billing or as a claim technical assistant for lost time claims. Works with in-house Technical Assistants, Special Investigators, Nurse Consultants, Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service.

New!

Tampa, FL1 day ago

We’re in search of highly motivated Casualty Claims Examiners with prior casualty and bodily injury experience, in private passenger automotive liability claims, looking to help deliver world-class service to our clients. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.

New!

Princeton, TX5 days ago

Bedford, NH14 days ago

$100,000–$140,000 Per Year
Full-time

CONSIDERED EXPERIENCE INCLUDES: Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobs #UnderwriterJobs. Described compensation is not definite nor precise and may be estimated and approximate and is negotiable depending on market conditions and candidate availability and other factors and is solely at the discretion of employers.

Quincy, MA11 days ago

$100,000–$140,000 Per Year
Full-time

New York, NY25 days ago

$25–$30 Per Hour
Temporary
Contractor
Full-time

When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). Please note that the salary range and/or hourly rate range of $25.00 - $30.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future.

Brea, CA10 days ago

$0–$0.01 Per Hour

Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost-effective manner and ensuring timely issuance of disbursements. Duties:Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.

Springfield, IL29 days ago

$110,000–$160,000 Per Year
Full-time
Employee

CONSIDERED EXPERIENCE INCLUDES: Insurance Claims Specialist Adjuster Examiner Analyst Attorney Environmental Toxic Tort Asbestos Pollution Health Hazard #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobsDISCLAIMER: We will make every effort to consider applications for all available positions and shall use one or more of the contact methods and addresses indicated in resume or online application. Diedre Moire CorporationEducation Requirements: Bachelor DegreeMinimum Experience Requirements: 5-10 yearsJob City Location: SpringfieldJob State Location: ILJob Country Location: USASalary Range: $110,000 to $160,000.

New!

Lakeland, FL1 day ago

$23.41–$29.41

We are looking for Personal Injury Protection (PIP) Claims Examiners in our Lakeland, FL office to deliver our promise to be there and assist our customers throughout the often complicated medical aspects of auto insurance claims. This job is a great fit for people who are continuous life learners, as PIP Claims Examiners are consistently challenged to learn more and increase their knowledge of our industry and company.

New!

Syosset, NY1 day ago

$29–$45.28

We are looking for Personal Injury Protection (PIP) Claims Examiners in our Melville, NY office to deliver our promise to be there and assist our customers throughout the often-complicated medical aspects of auto insurance claims. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate’s work experience, education and training, the work location as well as market and business considerations.

NEW YORK, NY30+ days ago

$50,000–$70,000 Per Year
Full-time
Employee

With decades of industry experience, we proudly serve clients through our affiliated entities - NYTIC, Emerald, Mediation Resolution Management, and Medical Management Group - offering innovative solutions, collaborative teamwork, and unwavering professionalism. We are seeking an experienced Claims Manager who is interested in growing and expanding their expertise across multiple entities, including NYTIC, Emerald, Mediation Resolution Management and Medical Management Group.

New!

San Antonio, TX6 days ago

$85,040–$162,550 Per Year

As a dedicated Injury Examiner you will be responsible to adjust complex auto and homeowner bodily injury claims, UM/UIM, and small business claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes.

Fort Wayne, IN7 days ago

$100,000–$160,000 Per Year

Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. Experience with AI-related inventions, cloud systems, cybersecurity, distributed systems, databases, networking, or similar software domains.

Los Angeles, CA27 days ago

Full-time
Employee

Minimum of 3 years of experience in healthcare fraud investigation/detection and/or healthcare related specialty including but not limited to; Pharmacy, DME, Mental Health, Behavioral Health, Hospice, Home Health, Dental etc. **Minimum of 3 years of experience in healthcare fraud investigation/detection **Healthcare-related specialty, including but not limited to: Pharmacy, DME, Mental Health, Behavioral Health, Hospice, Home Health, Dental, etc.

Phoenix, AZ30+ days ago

$85,040–$162,550 Per Year

Reviews investigative findings of claims identified as having confirmed elements of fraud, concealment, misrepresentation, or intentional act by evaluating the evidence to determine transfer or appropriation of claims disposition. As a dedicated SIU case manager, within defined guidelines and framework you will evaluate and conclude claims identified by SIU Investigators as having elements of fraud or an intentional act.

Rochester, NY7 days ago

$18–$19 Per Hour
Temporary
Contractor
Full-time

Consent to Communication and Use of AI Technology: By submitting your application for this position and providing your email address(es) and/or phone number(s), you consent to receive text (SMS), email, and/or voice communication whether automated (including auto telephone dialing systems or automatic text messaging systems), pre-recorded, AI-assisted, or individually initiated from Aditi Consulting, our agents, representatives, or affiliates at the phone number and/or email address you have provided. Reviews and interprets prescription and medical benefit coverage across all lines of business including Medicare D to determine what type of prior authorization review is required, documents any relevant medication history and missing information to assist the pharmacist/nurse/physician in the review process.

Remote30+ days ago

Remote

$76,829–$142,213 Per Year

Be able to seamlessly transition between various methods of inspection, including video, or photo, to write a damage estimate: • Possess strong organizational, time management, and prioritization skills to handle varying workloads due to seasonal volume changes and catastrophes. Upon completion of the training program, ideal candidates will transition into a property claims Examiner adjusting position, collaborating with vendors, and/or virtually inspecting and estimating losses damaged by fire, water, weather, or other unexpected events.

San Diego, California30+ days ago

$60,000–$116,000 Per Year

The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Whether you’re an experienced examiner or just starting your career, you’ll play a key role in ensuring timely and fair resolution of claims in compliance with California WCAB rules and regulations.

Hicksville, NY30+ days ago

They seek to hire a Senior Claims Examiner to manage a book of business for casualty claims. In this role you will be a part of a company that promotes a healthy work-life balance and emphasizes a "people first" environment.

Pasadena, California27 days ago

$24–$28 Per Hour

Communicate professionally with members and providers to resolve inquiries, follow up on pended claims, and complete corrections or adjustments. This position is ideal for someone who enjoys problem‑solving, working with complex benefit plans, and collaborating with both internal teams and external partners.

Springfield, MA30+ days ago

$23.46–$26.97 Per Hour

The Claims Examiner is responsible for providing claims production to the Claims Production Team to enable the administration of non-auto adjudicated claims which contributes to the overall success of Claims Production ensuring specific individual goals, plans, initiatives are executed and delivered in support of the team’s business strategies and objectives. • Actively pursues effective and efficient operations of their respective areas in accordance with Health New England’s Values, its Code of Conduct and the Associate Handbook, while ensuring the adequacy, adherence to and effectiveness of day-to-day business controls to meet obligations with respect to operational, compliance, and conduct.

Chino, CA7 days ago

$93,000–$104,000

This role requires strong technical expertise, sound judgment, and the ability to handle highly complex indemnity claims within established authority limits. This is a highly interactive role requiring regular communication with clients, claimants, attorneys, medical providers, and internal stakeholders.

"-", TX7 days ago

Remote

$85,000–$95,000

Comprehensive Claims Management: Independently investigate and evaluate Commercial Auto, PIP, and General Liability claims to ensure high-quality outcomes. As a Claims Examiner II, you will manage and resolve complex Commercial Auto, No-Fault/PIP, and General Liability claims from initial intake through final disposition.

New!

Houston, TXToday

$36–$41

In this role, you will independently manage a caseload of approximately 110–150 workers’ compensation claims, including complex files requiring advanced investigation, compensability analysis, reserve management, and ongoing medical oversight. You will work closely with claimants, employers, medical providers, attorneys, and internal stakeholders to ensure timely and compliant claim resolution in accordance with Texas workers’ compensation regulations.

Dallas, TX24 days ago

Remote

$45–$50 Per Hour

The ideal candidate will have strong experience in auto casualty, complex liability and coverage analysis, BI/UM/UIM, and No-Fault/PIP and a proven ability to investigate, evaluate, and resolve complex commercial and personal auto claims up to $1M. With delivery centers and offices across North America and India, we take pride in building long-term relationships and delivering excellence through innovation, collaboration, and integrity.

New!

Irving, TXToday

$76,000–$85,000

Operating with minimal supervision, this role requires strong analytical judgment, regulatory knowledge, and a commitment to delivering timely, accurate, and compliant claim outcomes. This organization is a professional risk management and claims administration firm committed to delivering responsive, compliant, and high-quality claims services.

New!

kAPOLEI, HIToday

$70,000–$95,000

This role requires frequent interaction with clients, claimants, medical providers, attorneys, vendors, nurse case managers, vocational case managers, and internal staff. At the direction of the Claims Supervisor and/or Claims Manager, the Claims Adjuster/Examiner II / III manages all aspects of workers’ compensation indemnity, medical-only, future medical, and litigated claims from inception through resolution, within established authority and company/client guidelines.

Irving, TX30+ days ago

Serves as a resource to assist with training new associates, retraining current associates on new/updated desktops/policies and reports staff progress, deficiencies, and training needs to management. This role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing.

Honolulu, HI30+ days ago

Full-time

The ideal candidate will excel at collaborating with third-party adjusters, vendors, and industry experts to ensure claims are handled efficiently and accurately while delivering exceptional service to agents and claimants. This role involves overseeing and managing complex property and casualty claims, including those related to building and structural damage, auto, and workers’ compensation.

Chandler, AZ27 days ago

$21–$23 Per Hour

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing Whole-Person care to Senior and Medicaid populations, through advanced value-based models. This individual works both independently and in conjunction with internal customers to adjudicate claims and responds to provider or client inquiries in an accurate, timely and courteous manner.

Boca Raton, Florida18 days ago

Overview: The Lead Claims Examiner is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. Communicates with internal managed care and medical resources to ensure coordination with medical providers, injured workers and employers in developing return to work strategies and treatment plans.

Kapolei, HI7 days ago

$85,000–$90,000

This role handles highly complex claims and plays a critical part in ensuring compliance with state regulations, timely investigations, accurate reserving, and effective claim resolution. The position requires strong analytical judgment, excellent communication skills, and consistent collaboration with clients, claimants, vendors, legal counsel, and internal teams.

Honolulu, HI10 days ago

$60,000–$90,000 Per Year

The Claims Examiner will oversee claim investigations, evaluate coverage and damages, coordinate with Third-Party Administrators (TPAs), field adjusters, consultants, and vendors, and negotiate claim settlements in accordance with company guidelines and regulatory requirements. This role is responsible for managing complex Property and Casualty insurance claims including structural property damage, auto liability, casualty, and workers’ compensation-related claims.

Pasadena, California17 days ago

$26–$29 Per Hour

We are seeking an experienced Medical Claims Examiner to review, analyze, and adjudicate medical claims for accuracy, compliance, and medical necessity. Identify coding discrepancies, overpayments, and potential fraud or abuse.

TX30+ days ago

Remote

$31.54–$37.94 Per Hour

The Claims Examiner will adjust workers compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. Provide direction to Assistant Claims Examiners and Claims Technicians and assist with training, coaching, and mentoring as needed for them to support daily claims tasks.

Irving, TX30+ days ago

Full-time

This role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing. Job Summary: The Senior Claims Examiner is responsible for reviewing, analyzing, researching, and resolving complex medical claims in accordance with claims processing guidelines and desktops, as well as, ensuring compliance with federal regulations.

New!

Kansas City, MO2 days ago

Good understanding or ability to learn in house systems (Workflow/Imaging System, Life Insurance Policy Administration systems, Microsoft Office applications). Our newly renovated offices are conveniently located in downtown Kansas City, within walking distance of your favorite restaurants and attractions.

Concord, CA30+ days ago

Remote

$28.20–$31.53 Per Hour

The Assistant Claims Examiner will provide clerical and technical assistance to Senior Claims Examiners and administer Medical Only claims, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, and setting reserves. Immediate need for an Assistant Claims Examiner to support our clients' Workers Compensation department and can be located anywhere in the state of California.

Anaheim, CA11 days ago

$60,000–$100,000 Per Year

Our client, a large and growing insurance carrier, is seeking a Third Party Liability Claims Examiner to manage complex bodily injury, property damage, and litigated liability claims related to commercial trucking and business insurance policies. This role is responsible for investigating, evaluating, negotiating, and resolving third-party liability claims while coordinating with attorneys, TPAs, claimants, and internal teams.

Great Neck, NY11 days ago

$60,000–$100,000 Per Year

San Antonio, TX30+ days ago

$19–$21
Contractor

Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. This position is responsible for accurately processing health plan delegated claims, addressing provider inquiries via phone, and handling various administrative tasks within the claims department.

New!

Scottsdale, Arizona6 days ago

Proactively manages claim files from inception to closure, including identification and investigation of coverage, liability and damage issues, determination and efficient execution of an appropriate plan of action, and prompt, economical file resolution, in compliance with Department guidelines and best practices. The Claims Examiner I’s primary job function includes efficiently and effectively handling primarily basic third-party general liability losses in a “paperless” environment.

Irvine, California20 days ago

$110,000–$125,000 Per Year

This role actively supports and participates in the company’s culture of continuous learning and innovation, including engagement in innovation groups focused on identifying opportunities for process improvement, enhancement, and transformational change. Key functions include but are not limited to: Adjust all aspects of complex claims and loss notices, including coverage and compensability analysis, reserve setting, reinsurance reporting, and coverage litigation.

Columbus, OH30+ days ago

Full-time

The occupant is expected to freely operate the following tools and equipment: personal computer (including word processing, spreadsheet, and database programs); printer; calculator; telephone; copier; fax machine. The Workers Compensation Claims Examiner is primarily responsible for analyzing and processing complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim.

Jersey City, New Jersey30+ days ago

$90,000–$140,000 Per Year

We provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers’ compensation, along with claim services, providing expertise to meet the unique business needs of our customers. Responsibilities: The Senior Claims Examiner will be responsible for reviewing, processing, investigating, evaluating, negotiating and the settling of assigned property damage or bodily injury claims with the authority level generally up to $100,000.00.

New!

Irving, TXToday

$36–$38.46

This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office; therefore consistently being at work in the office, in a timely manner, is inherently required of this position. Education/Experience: High School Diploma or GED required; Bachelor’s degree in related field (preferred); five (5) or more years related experience; or equivalent combination of education and experience.

Dubuque, IA30+ days ago

We also understand that our growth is fueled by becoming better, not bigger – growth funds investments in new resources to better serve our clients and provide the career opportunities our employees want and deserve. This position is responsible for the delivery of excellent claims service to include accurate and timely claims processing and prompt and professional communication with clients and healthcare providers.

Scottsdale, Arizona30+ days ago

$87,600–$112,000 Per Year

Overview: Responsible for the prompt and efficient examination, investigation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds and claimants, ensuring that company resources are utilized in a cost effective manner in the process. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations.

Memphis, TN30+ days ago

Remote

Contractor

Primary purpose: To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.

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Claims Examiner Jobs in the United States

Jobs

Hybrid Supplemental Health Claims ExaminerJepsen Investments, Inc.

Claims ExaminerIconma

Casualty Claims Examiner ($2,500 Sign-On Bonus) - Tampa, FLGEICO

Casualty Claims Examiner ($2,500 Sign-On)GEICO

Claims Examiner Medical MalpracticeDiedre Moire Corporation, Inc.

Claims Examiner MedMalDiedre Moire Corp.

Claims ExaminerAtria Consulting

Claim Examiner- WCTPI Global Solutions

Insurance Claims EnvironmentalDiedre Moire Corp.

Personal Injury ExaminerGEICO

PIP ExaminerGEICO

Claims ManagerJones Jones LLC

Injury ExaminerUSAA

Software Patent Prosecution AttorneyJobot

Special Investigations Unit (SIU) Investigator – Healthcare FraudINFT Solutions, Inc

SIU Case ManagerUSAA

Pharmacy Authorization TechnicianAditi Consulting

Property Claims Examiner IIMercury Insurance Services, LLC

Claims Examiner/Associate Claims ExaminerBerkley

Senior Claims ExaminerGeneral Placement Service

Health Claims ExaminerUltimate Staffing Services

Claims ExaminerBaystate Health

Workers Compensation Claims ExaminerTEEMA Group

Commercial Auto & General Liability Claims Examiner IITEEMA Group

Workers Compensation Claims ExaminerTEEMA

Claims Examiner - Auto (1486336)BC Forward

Claims Examiner IIITEEMA Group

Workers Compensation Claims Examiner II/III - HybridTEEMA

Claims Examiner Senior - Health Plan AdminCHRISTUS Health

Claims Examiner - HYBRIDDB Insurance Co., Ltd.

Claims ExaminerArizona Priority Care

Lead Claims Examiner IAmTrust Financial Services, Inc.

Workers Compensation Claims Examiner II/IIITEEMA Group

Claims Examiner - Property and Casualty Insurance - Base Salary to 90k/year - Honolulu, HIAllSearch Professional Staffing

Medical Claims ExaminerUltimate Staffing Services

Sr. Workers' Compensation Claims Examiner (Full Remote - TX) (Contract to Perm)Johnson Service Group

Senior Medical Claims ExaminerMacpower Digital Assets Edge LLC

Complex Claims Examiner IAmerico Financial Life and Annuity

Assistant Workers' Compensation Claims Examiner (Temp - Perm) (Hybrid or Remote) - CAJohnson Service Group

Third Party Liability Claims Examiner - Insurance Carrier - Base Salary to 100k/year - Anaheim, CAAllSearch Professional Staffing

Third Party Liability Claims Examiner - Insurance Carrier - Base Salary to 100k/year - Great Neck, NYAllSearch Professional Staffing

Claims ExaminerJobot

Claims Examiner IBerkley

Senior Claims ExaminerBerkley

Workers Compensation Claims ExaminerSuretyHR

Sr. Claims ExaminerBerkley

Workers Compensation Claims Examiner IIITeemaGroup

Claims ExaminerCottingham & Butler

Senior Claims ExaminerAmTrust Financial Services, Inc.

Claims Examiner - GL PLApidel Technologies

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