443 claims reviewer jobs at 305 companies in United States
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CLAIMS REVIEWER I
Baltimore, Maryland, United States
$44k-$61k/yr HybridFull Time
1+ YOEHigh school diploma or equivalency and clerical experience required. Must have six months of end-to-end claims experience and one year of data entry experience; Microsoft Office skills preferred.
CompHub, Microsoft Office, Microsoft Word, Microsoft Excel, Microsoft Outlook, Microsoft PowerPoint
1mo
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Claims Auditor, Reviewer and Coder
United States
RemoteFull Time
5+ YOEBachelor's or master's in health profession preferred; 5+ years claims/managed care experience; expertise in CPT/HCPCS/ICD/DRG coding, claims auditing, and data analysis; RHIA/RHIT/CCS desirable; Microsoft Office proficiency.
Microsoft Excel, Microsoft Outlook, Microsoft SharePoint, Microsoft Word, Microsoft PowerPoint, Teams
1mo
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Claims Auditor, Reviewer and Coder
United States
OnsiteFull Time
5+ YOE5+ years working with health plan claims data, expertise in medical coding (CPT, HCPCS, ICD), claims auditing and quality assurance; proficiency with Microsoft Office and communication tools; bachelor's or master's in a health profession preferred.
Microsoft Excel, Microsoft Outlook, Microsoft SharePoint, Microsoft Word, Microsoft PowerPoint, Microsoft Teams
1w
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Eligibility Reviewer
Boston or Maine
$25/hr RemoteFull Time
Experience reviewing applications, eligibility, case files, or claims; strong analytical, organizational, communication, confidentiality, and Microsoft Office skills. Bachelor's degree preferred.
Microsoft Office, Microsoft Word, Microsoft Excel
3w
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Nurse Reviewer, RN
Cheyenne, Wyoming, United States
HybridFull Time
Active unrestricted Wyoming RN license required; review claims and appeals, apply medical policy using Interqual, collaborate with providers and pharmacists, and exercise critical thinking.
Interqual
3w
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Nurse Reviewer - Medicaid
United States
$66k-$106k/yr RemoteFull Time
3+ YOEActive nursing or physical therapy license, 3+ years clinical or medical claims review experience, strong investigative, communication, organization, and PC skills; U.S. citizenship required.
3mo
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Claims - Claims Examiner
Pensacola, Florida, United States
OnsiteFull Time
2+ YOEReview and adjudicate long-term care claims; analyze documentation; ensure HIPAA compliance.
Healthcare claims systems, Microsoft Excel, Microsoft Word, Microsoft Outlook
3w
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Nurse Reviewer - Medicaid
United States
$66k-$106k/yr RemoteFull Time
3+ YOEActive nursing or physical therapy license, 3+ years clinical or claims review experience, bachelor’s/master’s/associate with corresponding experience, strong investigative and communication skills, U.S. citizenship required.
3mo
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340B Reviewer Clerk
Nipomo, California, United States
$26-$29/hr OnsiteFull Time
Performs chart reviews for 340B claims, requires HS diploma/GED, understanding of finance, Microsoft Office/Excel and Google Suite skills, CA Class C driver, background check, and required immunizations.
Microsoft Office, Microsoft Excel, Google Suite, EHR, Athena
3mo
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Hospital Claims Processor V
New York, New York, United States
OnsiteFull Time
2+ YOEProcess and review hospital claims; ensure eligibility, benefits, and resolution; requires 2+ years claims experience; HS diploma; knowledge of ICD/CPT; QNXT.
QNXT, ICD-9, ICD-10, CPT, Claims system
2mo
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QRM Phy Reviewer 1
Atlanta, Georgia, United States
OnsiteFull Time
5+ YOEPhysician with minimum 5 years medical practice; strong medical judgment, communication, and interpersonal skills; working knowledge of personal computers and familiarity with TSPMG delivery system; utilization review or claims experience preferred.
Epic
2w
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Claims Officer
San Bernardino, California, United States
$6k-$8k/mo HybridFull Time
Direct and coordinate review and processing of statewide damage and tort claims, investigate and evaluate liability claims, support Legal Office attorneys, process claims ≤$12,500, represent department in Small Claims Court, and meet Analyst II minimum qualifications.
2mo
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Claims Adjustor I
Birmingham, Alabama, United States
OnsiteFull Time
Medical-only claims adjuster responsible for handling a dedicated account and reviewing medical claims.
1mo
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Claims Consultant
Orange City, Florida, United States
$48k-$55k/yr OnsiteFull Time
4+ YOEExperience with disability/FMLA/PFL claims, medical file review, benefits determination, claim adjudication, strong analytical and communication skills, and MS Office proficiency.
FINEOS, Microsoft Excel, Microsoft Word, Microsoft PowerPoint
2w
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Claims Specialist
La Crosse, Wisconsin, United States
$40k-$74k/yr HybridFull Time
Subject matter expert in claims processes; review, analyze and process claims; assist offices with claim entry and policy questions; strong communication and decision-making; Windows/Word/Excel competency; degree preferred or relevant experience.
Windows, Microsoft Word, Microsoft Excel, Microsoft Teams
1d
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Nurse Reviewer (Registered Nurse) - Remote
Texas, United States
$78k-$88k/yr RemoteFull Time
5+ YOEActive unrestricted U.S. and compact multistate RN licenses; 5+ years inpatient hospital experience; 2+ years utilization review or claims auditing experience; Milliman or InterQual experience; computer proficiency.
Microsoft Windows, Microsoft Outlook, Microsoft Excel, Microsoft Word, Microsoft PowerPoint, Milliman, InterQual
2w
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Claims Specialist
Dearborn, Michigan, United States
OnsiteFull Time
3+ YOEPrior OEM claim entry and warranty review experience, 3+ years claims experience, strong analytical and communication skills, accuracy, Microsoft Word and Excel familiarity; Associates degree preferred.
Microsoft Word, Microsoft Excel
1w
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Contractual Reviewer-Senior
Buffalo or Williamsville
$23-$28/hr HybridFull Time
3+ YOEHigh school diploma or GED and 3 years of member- or provider-focused experience required; associate degree and healthcare benefits, contracts, and medical terminology experience preferred.
claims systems
2w
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Claims Supervisor
San Antonio, Texas, United States
OnsiteFull Time
5+ YOE3+ Mgmt5+ years property claims adjusting experience, 3+ years supervisory experience, strong leadership and writing skills, knowledge of claim procedures and insurance regulations, ability to review estimates and handle escalations.
Xactimate
2mo
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Claims Supervisor
Kansas City, Missouri, United States
HybridFull Time
Supervise workers' compensation claims staff, review open claim files, ensure timely reserves, coach adjusters, coordinate training, maintain regulatory compliance, and obtain an adjuster license within six months.
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