Claims Examiner jobs in USA
528 claims examiner jobs found: showing 351 - 400
Claims Examiner I
Company: MagnaCare |
Primary Responsibilities Review and adjudicate claims submitted for reimbursement that fall outside auto adjudication... contracts, medical terminology, and claims processing procedures. Prior experience processing claims is required. Minimum 1Location: Las Vegas, NV, USA
| Salary: unspecified | Date posted: 23 Jun 2026
Medical Management - Medical Review Examiner Nurse 135
Company: CommunityCare |
JOB SUMMARY: The Medical Review Examiner Nurse is responsible for auditing provider and facility claims. Identifying..., waste and abuse, as it relates to provider billing practices. KEY RESPONSIBILITIES: Review claims by requesting medicalLocation: Tulsa, OK, USA
| Salary: unspecified | Date posted: 23 Jun 2026
Investigative Auditor
Company: Contact Government Services |
claims, reimbursement data, procurement records, grant expenditures, and related financial records. * Conduct healthcare... claims analysis involving Medicare, Medicaid, TRICARE, VA, and other federally funded healthcare programs. * AssistLocation: Albany, NY, USA
| Salary: US$90000 - 120000 per year | Date posted: 23 Jun 2026
Claims Hmo - Complex Claims Specialist 140
Company: CommunityCare |
of claims processing. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate...JOB SUMMARY: The Complex Claims Specialist is responsible for examining claims that require review prior to beingLocation: Tulsa, OK, USA
| Salary: unspecified | Date posted: 23 Jun 2026
Claims Hmo - Complex Claims Specialist 140
Company: CommunityCare |
of claims processing. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate...JOB SUMMARY: The Complex Claims Specialist is responsible for examining claims that require review prior to beingLocation: Tulsa, OK, USA
| Salary: unspecified | Date posted: 22 Jun 2026
Senior Fraud Analyst
Company: AAA Life Insurance Company |
of referrals. Evaluate claims, transactions, applications, and account activities to identify fraud indicators and inform..., NICB, or CFCI, a plus Certifications such as Certified Fraud Examiner (CFE), Certified Financial Crimes Investigator (CFCILocation: Livonia, MI, USA
| Salary: unspecified | Date posted: 22 Jun 2026
Claims Examiner
Company: Peyton Resource Group |
Position Summary We are seeking a detail-oriented Claims Examiner & Support Specialist I to support healthcare claims... operations through accurate claims processing, provider communication, and administrative support. This role is responsibleLocation: San Antonio, TX, USA
| Salary: unspecified | Date posted: 22 Jun 2026
Claims Hmo - Claims Examiner 140
Company: CommunityCare |
JOB SUMMARY: The Claims Examiner is responsible for examining claims that require review prior to being adjudicated.... The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to payLocation: Tulsa, OK, USA
| Salary: unspecified | Date posted: 22 Jun 2026
Claims Examiner - Workers Compensation
Company: Apidel Technologies |
skills Claims Examiner - Workers Compensation... or technically difficult workers\' compensation claims to determine benefits due; to work with high exposure claims involvingLocation: Ontario, CA, USA
| Salary: unspecified | Date posted: 20 Jun 2026
Claims Investigator/examiner
Company: AIDS Healthcare Foundation |
for the organizations multiple health plans and AHF grants and contracts. The Claims Investigator-Examiner contributes to AHF.... The Claims Investigator-Examiner enhance the experience of providers and the organization by being knowledgeable, friendlyLocation: Los Angeles, CA, USA
| Salary: unspecified | Date posted: 20 Jun 2026
Sr Claims Examiner (tpa Oversight)
Company: The Jonus Group |
Our client is seeking an experienced Commercial General Liability Claims Specialist to provide claims oversight... Liability claims Conduct claims reviews, approve reserves, and direct claims to closure Collaborate with various internalLocation: Albany, CA, USA
| Salary: unspecified | Date posted: 19 Jun 2026
Claims Examiner Workers Compensation I Nv Experience Required
Company: Sedgwick |
in Financial Services & Insurance Claims Examiner Workers Compensation I NV experience...s best brands? Apply your workers compensation examiner knowledge and experience to adjudicate complex customer claims in theLocation: USA, USA
| Salary: US$60234 - 90000 per year | Date posted: 19 Jun 2026
Unclaimed Property Fraud Examiner (claims Representative 2)
Company: State of Oregon |
: $4,738 - $7,247 Position Type: Employee Position Title: Unclaimed Property Fraud Examiner (Claims Representative 2...) Job Description: Oregon State Treasury is recruiting for the position of Unclaimed Property Fraud Examiner within the Trust Property DivisionLocation: Salem, OR, USA
| Salary: US$4738 - 7247 per month | Date posted: 19 Jun 2026
Claims Examiner Workers Compensation I Tx Experience Required
Company: Sedgwick |
in Financial Services & Insurance Claims Examiner Workers Compensation I TX experience...s best brands? Apply your workers compensation examiner knowledge and experience to adjudicate complex customer claims in theLocation: USA, USA
| Salary: US$60234 - 85000 per year | Date posted: 19 Jun 2026
Claims Examiner Workers Compensation I Ne Jurisdiction Experience Required
Company: Sedgwick |
in Financial Services & Insurance Claims Examiner Workers Compensation I NE jurisdiction experience...s best brands? Apply your workers compensation examiner knowledge and experience to adjudicate complex customer claims in theLocation: USA, USA
| Salary: US$60234 - 90000 per year | Date posted: 19 Jun 2026
Claims Examiner, Workers' Compensation
Company: AssuredPartners |
communities we serve. At Gallagher, were united by a commitment to excellence and innovation. As a Claims Examiner, youll... take ownership of indemnity claims, ensuring timely and accurate resolution. Youll use your strong customer service skillsLocation: Rancho Cordova, CA, USA
| Salary: unspecified | Date posted: 19 Jun 2026
Senior Workers' Compensation Claims Examiner | Remote
Company: KING'S INSURANCE STAFFING LLC |
Our client, an A-rated Insurance Carrier, is seeking to add a Senior Workers' Compensation Claims Examiner... Time claims from inception to close. Qualified candidates must reside in the Midwest and possess a strong knowledgeLocation: USA, USA
| Salary: US$80000 - 98000 per year | Date posted: 19 Jun 2026
Claims Examiner Workers Compensation I Ne Jurisdictions I Remote
Company: Sedgwick |
in Financial Services & Insurance Claims Examiner Workers Compensation I NE Jurisdictions I Remote...s best brands? Apply your workers compensation examiner knowledge and experience to adjudicate complex customer claims in theLocation: USA, USA
| Salary: US$63404 - 90000 per year | Date posted: 19 Jun 2026
Workers Compensation Claims Examiner | Dedicated Client | Ny Jurisdiction Knowledge & Ny Licensing Required
Company: Sedgwick |
in Financial Services & Insurance Workers Compensation Claims Examiner | Dedicated Client | NY Jurisdiction Knowledge & NY... customer claims in the context of an energetic culture. Deliver innovative customer-facing solutions to clients who representLocation: Syracuse, NY, USA
| Salary: unspecified | Date posted: 19 Jun 2026
Workers Compensation Claims Examiner | Hybrid | Orange, Ca
Company: Sedgwick |
in Financial Services & Insurance Workers Compensation Claims Examiner | HYBRID | Orange, CA Are you looking for an opportunity...? Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver innovativeLocation: Orange, CA, USA
| Salary: US$80000 - 105000 per year | Date posted: 19 Jun 2026
Certified Medical Coder I (professional Review Specialist I)
Company: CorVel |
and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data... in the following areas preferred: Medical bill auditing Knowledge of workers' compensation claims process ProspectiveLocation: Syracuse, NY, USA
| Salary: US$19.24 - 31.04 per hour | Date posted: 19 Jun 2026
Claims Examiner Workers Compensation I Ny Experience Required
Company: Sedgwick |
in Financial Services & Insurance Claims Examiner Workers Compensation I NY experience...s best brands? Apply your workers compensation examiner knowledge and experience to adjudicate complex customer claims in theLocation: USA, USA
| Salary: US$60234 - 90000 per year | Date posted: 18 Jun 2026
Non-clinical - Finance/accounting/claims Examiner
Company: US Tech Solutions |
Responsibilities: The claims examiner reports directly to the claims manager. They are primarily responsible for the processing...Job Description: Must have listed claims reimbursement experience Must have DOFR Must have processed lab claimsLocation: Whittier, CA, USA
| Salary: unspecified | Date posted: 18 Jun 2026
Forensic Financial Analyst (medicaid Fraud) 23-e-32, Springfield
Company: Illinois Attorney General (IL) |
. A Certified Fraud Examiner (CFE) Certification or studying towards, is preferred. The ability to demonstrate strong leadership... care industry and medical coding concepts (CPT, ICD-9/10, DRGs, HCPCS) and/or experience analyzing health care claims dataLocation: USA, USA
| Salary: US$70000 - 110000 per year | Date posted: 18 Jun 2026
Property Claims Examiner Ii
Company: Mercury Insurance Services, LLC |
, water, weather, or other unexpected events. The Property Claims Examiner will apply knowledge of current Company policies... is a plus 3-5+ years equivalent industry experience is preferred Knowledge and Skills: As a Property Claims Examiner 2Location: USA, USA
| Salary: US$76829 per year | Date posted: 18 Jun 2026
Senior Investigator - Lead Validation (healthcare Fwa)
Company: Cotiviti |
. Utilizes data analytics, claims review, and industry intelligence to detect potential fraud, waste, abuse, or non-compliance.... Leverages claims data, dashboards, and predictive models to identify providers exhibiting atypical billing patterns or potentialLocation: USA, USA
| Salary: US$70000 - 90000 per year | Date posted: 18 Jun 2026
Disability Determination Examiner I - Charleston, Columbia, Greenville Offices
Company: State of South Carolina |
benefits, and a positive work-life balance! Under direct supervision, a disability determination examiner I evaluates a basic... caseload of claims for the Social Security Administration after completing the provided training. In this positionLocation: South Carolina, USA
| Salary: US$39300 - 53100 per year | Date posted: 18 Jun 2026
Senior Auto Liability Special Handling Unit Senior Claims Adjuster
Company: AssuredPartners |
deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving... claims, involving suspected misrepresentation, organized activity or material inconsistencies. While this is an individualLocation: Mechanicsburg, PA, USA
| Salary: unspecified | Date posted: 18 Jun 2026
Market Conduct Examiner
Company: Montana State Government |
has an opportunity for a full-time Market Conduct Examiner in the Market Conduct Bureau in Helena, Montana. This position helps protect... handling, producer licensing, marketing and sales, policyholder service, underwriting and rating, and claims practicesLocation: Helena, MT, USA
| Salary: unspecified | Date posted: 18 Jun 2026
Senior (special Investigation Unit (siu) Investigator
Company: AAA Life Insurance Company |
, underwriting, claims, and identity-related fraud schemes. Direct end-to-end case strategy, overseeing evidence development..., including the full policy lifecycle (from application, underwriting, policy servicing, and claims) and associated fraud risks. 8Location: Livonia, MI, USA
| Salary: unspecified | Date posted: 18 Jun 2026
Senior Regional Manager, Asset Protection
Company: Equinox |
, including theft, fraud, liability claims, litigation, and complimentary membership abuse. Conduct and ensure timely completion...). Advanced certifications: ASIS Certified Protection Professional (CPP) and/or Certified Fraud Examiner (CFE). BilingualLocation: New York City, NY, USA
| Salary: US$124000 - 134000 per year | Date posted: 17 Jun 2026
Claims Assistant 2
Company: Association County Commissioners of GA |
claim before forwarding to Claims Examiner by appropriate party; verifies statistical or other records for accuracy...General Definition of Work Performs intermediate skilled administrative support work entering claims into theLocation: Atlanta, GA, USA
| Salary: US$45000 - 55000 per year | Date posted: 17 Jun 2026
Siu Lead Investigator
Company: LHC Group |
) Professional certification as a Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI) or similar... insurance claims industry 2+ years of knowledge and/or experience with medical/behavioral health codes and service delivery 2Location: Minneapolis, MN, USA
| Salary: US$72800 - 130000 per year | Date posted: 17 Jun 2026
Principal Investigator
Company: LHC Group |
fraud, waste, and abuse. The Principal Investigator will utilize claims data, applicable guidelines, and other sources...) Accredited Health Care Fraud Investigator (AHFI) Certified Fraud Examiner (CFE) CPT & ICD Coding experience SpecializedLocation: Minnetonka, MN, USA
| Salary: US$72800 - 130000 per year | Date posted: 17 Jun 2026
Administrative Appeals Judge (exempt)
Company: Washington State |
agencies. The boards issue decisions setting forth legal analyses of claims, and if a case goes to hearing, the boards issue..., hearings examiner or presiding officer; Experience as a mediator, or a willingness to complete a course of trainingLocation: Olympia, WA, USA
| Salary: US$125000 - 141837.12 per year | Date posted: 17 Jun 2026
Senior Investigator Pharmacy - Los Angeles County, Ca
Company: LHC Group |
of healthcare fraud, waste and abuse. The Senior Investigator will utilize claims data, applicable guidelines and other sources... level of proficiency with Microsoft Excel and Word Intermediate level of knowledge in pharmacy claims processing AbilityLocation: Los Angeles, CA, USA
| Salary: US$60200 - 107400 per year | Date posted: 17 Jun 2026
Certified Professional Coder - Professional Review Specialist Ii
Company: CorVel |
and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data... in the following areas preferred: Medical bill auditing Knowledge of workers' compensation claims process ProspectiveLocation: Hartford, CT, USA
| Salary: US$22.17 - 35.66 per hour | Date posted: 17 Jun 2026
Senior Claim Examiner I
Company: AmTrust Financial |
Overview: The Lead Claim 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 medicalLocation: Latham, NY, USA
| Salary: US$77500 - 105000 per year | Date posted: 17 Jun 2026
Siu Senior Recovery Resolution Analyst
Company: LHC Group |
, CPMA) or RHIT 2+ years of experience within the health insurance claims industry 1+ years of knowledge...+ years of investigative experience with fraud investigations Professional certification as a Certified Fraud Examiner (CFELocation: Plymouth, MN, USA
| Salary: unspecified | Date posted: 17 Jun 2026
Appeals Examiner - West Sacramento, Ca (on-site)
Company: Gainwell Technologies |
. Summary As Appeals Examiner - West Sacramento, CA (On-site), you can contribute your skills as we harness the power... and quality standards. Resubmit and adjust claims on approved appeals with the proper claim data correction and documentationLocation: West Sacramento, CA, USA
| Salary: US$37500 - 53500 per year | Date posted: 17 Jun 2026
Appeals Examiner - West Sacramento, Ca (on-site)
Company: Gainwell Technologies |
. Summary As Appeals Examiner - West Sacramento, CA (On-site), you can contribute your skills as we harness the power... and quality standards. Resubmit and adjust claims on approved appeals with the proper claim data correction and documentationLocation: West Sacramento, CA, USA
| Salary: US$37500 - 53500 per year | Date posted: 16 Jun 2026
Claims Examiner - Workers Compensation (on-site Ontario, California Or Remote In California)
Company: Sedgwick |
in Financial Services & Insurance Claims Examiner - Workers Compensation (On-Site Ontario, California or REMOTE in California...s best brands? Apply your knowledge and experience to adjudicate complex workers compensation claims in the contextLocation: Ontario, CA, USA
| Salary: US$85000 - 95000 per year | Date posted: 16 Jun 2026
Workers Compensation Claims Examiner - Orange, Ca
Company: Sedgwick |
in Financial Services & Insurance Workers Compensation Claims Examiner - Orange, CA Are you looking for an opportunity...? Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver innovativeLocation: Orange, CA, USA
| Salary: US$80000 - 105000 per year | Date posted: 16 Jun 2026
Garage Keeper Claims Examiner – Bodily Injury
Company: The Jonus Group |
We are seeking an experienced Garage Keeper Claims Examiner - Bodily Injury to investigate, evaluate, negotiate..., and resolve complex bodily injury claims arising from garage operations, auto dealerships, repair facilities, service centersLocation: Chicago, IL, USA
| Salary: US$75000 - 110000 per year | Date posted: 16 Jun 2026
Senior Workers’ Compensation Claims Examiner | Remote
Company: KING'S INSURANCE STAFFING LLC |
Our client is looking for an experienced Workers' Compensation Claims Examiner to join their growing Texas claims team.... This position is ideal for a claims professional who thrives in a fast-paced environment and has a strong background handling TexasLocation: USA, USA
| Salary: US$75000 - 83000 per year | Date posted: 16 Jun 2026
Claims Examiner - Workers Compensation (hybrid- West Hills, Ca/3 Days Remote)
Company: Sedgwick |
in Financial Services & Insurance Claims Examiner - Workers Compensation (HYBRID- West Hills, CA/3 Days Remote...s best brands? Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic cultureLocation: West Hills, CA, USA
| Salary: US$80000 - 90000 per year | Date posted: 16 Jun 2026
Senior Claim Examiner I
Company: AmTrust Financial |
Overview The Lead Claim 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 medicalLocation: Latham, NY, USA
| Salary: US$77500 - 105000 per year | Date posted: 16 Jun 2026
Claims Examiner - Workers Compensation | Southeast Jurisdictions | Remote
Company: Sedgwick |
in Financial Services & Insurance Claims Examiner - Workers Compensation | Southeast Jurisdictions | Remote...s best brands? Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic cultureLocation: USA, USA
| Salary: unspecified | Date posted: 13 Jun 2026
Physician (radiology-diagnostic) Gp
Company: unknown |
a talented Diagnostic Radiologist to lead our imaging services in Armed Forces Medical Examiner System (AFMES). "Unlike... Department of War." Global Reach: AFMES is the only medical examiner system authorized to support the Department of WarLocation: Dover, DE, USA
| Salary: unspecified | Date posted: 13 Jun 2026
Senior Analyst - Payment Integrity Analytics
Company: Gainwell Technologies |
(FWA) analytic models to Medicaid claims data and delivering monthly, prequalified FWA lead referrals. This role emphasizes... FWA analytic models to Medicaid claims data to identify potential fraud, waste, and abuse. Deliver monthly, prequalified