Explore Claims Specialist Jobs

Discover Claims Specialist opportunities for experienced professionals on Ladders. Browse vetted roles with salaries of $100,000 or more across insurance, healthcare, workers’ compensation, and other industries. Claims specialists investigate claims, assess documentation, interpret policies, and help organizations reach accurate, timely resolutions.

What Does a Claims Specialist Do?

Responsibilities vary by employer and specialty, but may include reviewing claim submissions, gathering evidence, interviewing claimants or witnesses, evaluating coverage and liability, calculating payments, and documenting decisions. Senior specialists may manage complex or high-value cases, resolve escalations, identify fraud indicators, and coordinate with legal, medical, underwriting, or customer service teams.

Skills and Qualifications

Employers commonly seek strong analytical, communication, and negotiation skills; close attention to detail; and the ability to manage sensitive information and competing deadlines. Familiarity with insurance policies, claims platforms, regulatory requirements, and industry-specific practices can be valuable. Some positions require relevant licenses, certifications, or experience in a specialty such as property and casualty, medical, disability, or workers’ compensation claims.

Find Your Next Claims Specialist Role

Claims Specialist job titles and requirements differ across organizations. Explore opportunities on Ladders to compare roles, industries, and compensation, and focus your search on positions that align with your experience and career goals. Ladders features vetted professional jobs paying $100,000 or more.

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$78K - $113K *

Join us to lead the Professional Coding Operations team, ensuring accurate coding practices and compliance. Collaborate with stakeholders, mentor staff, and drive improvements in coding efficiency and...

United StatesRemote

1 week ago

  •   5 - 7 years exp.  •   Healthcare

$91K - $114K *

Support clinical trial monitoring activities, ensuring protocol compliance and data integrity while collaborating with site staff to advance innovative treatments and therapies...

RemoteRemote

3 days ago

  •   Less than 5 years exp.  •   Healthcare

$73K - $88K *

Accelerate progress at expanding customer accounts by driving annual recurring revenue and enhancing retention through structured sales strategies and digital engagement, while managing a high-volume...

United StatesRemote

1 week ago

  •   Less than 5 years exp.  •   Media

$80K - $95K *

Join a dynamic team as you manage clinical research sites, ensuring compliance and quality throughout all study phases. Build strong relationships, oversee monitoring activities, and contribute to tea...

United StatesRemote

3 weeks ago

  •   Less than 5 years exp.  •   Pharmaceuticals & Biotech

$87K - $122K *

Drive impactful change as a Senior Product Analyst, leading cross-functional teams to deliver secure, scalable Workday Compensation solutions. Mentor junior analysts and influence strategic decisions...

Mississauga, ONRemote

1 week ago

  •   Less than 5 years exp.  •   Retail & Consumer Goods

$106K - $175K *

Join a dynamic team to drive growth and profitability through strategic partnerships with agents and brokers. Leverage your expertise in sales and insurance to optimize relationships and implement inn...

RemoteRemote

4 days ago

  •   5 - 7 years exp.  •   Finance & Insurance

$124K - $170K *

Champion regulatory strategies to accelerate product approvals and compliance. Lead a dynamic team in supporting innovative medical devices, ensuring alignment with global regulations while fostering...

RemoteRemote

1 week ago

  •   5 - 7 years exp.  •   Healthcare

$80K - $90K *

Analyze and deliver data management solutions to support public health research, utilizing advanced statistical software and collaborating with project leaders to enhance data quality and reporting fo...

Massachusetts, USRemote

3 weeks ago

  •   Less than 5 years exp.  •   Education, Government & Non-Profit

$88K - $105K *

Lead the charge in managing complex subcontracts, ensuring compliance and effective negotiation while supporting procurement across diverse projects in a dynamic, remote environment...

Virginia, USRemote

Today

  •   Less than 5 years exp.  •   Information Technology

$120K - $150K *

Transform the delivery landscape by leading cross-functional initiatives, mentoring analysts, and driving strategic solutions across business units and external partners. Engage deeply in project exec...

United StatesRemote

Today

  •   5 - 7 years exp.  •   Finance & Insurance

$115K - $158K *

Shape the future of healthcare by leading the Organic Risk Adjustment program. Drive strategic initiatives, foster collaboration across teams, and implement innovative solutions to enhance performance...

United StatesRemote

2 days ago

  •   Less than 5 years exp.  •   Healthcare

$88K - $105K *

Analyze trends and develop strategic reports to enhance revenue cycle efficiency. Collaborate with management and key departments to identify opportunities and risks, presenting data-driven insights t...

Los Angeles, CARemote

1 week ago

  •   Less than 5 years exp.  •   Healthcare

$175K - $334K *

Unlock potential by providing expert legal counsel in healthcare regulations, guiding internal stakeholders and senior management while ensuring compliance and mitigating risks across the organization...

Rhode Island, USRemote

2 days ago

  •   8 - 10 years exp.  •   Pharmaceuticals & Biotech

$85K - $114K *

Elevate patient care as a remote RN Case Manager, coordinating quality healthcare for ESKD and CKD patients across multiple states. Collaborate with healthcare teams to ensure effective care delivery...

California, USRemote

3 weeks ago

  •   5 - 7 years exp.  •   Healthcare

$73K - $125K *

Transform clinical review processes by conducting thorough prepayment and post-payment assessments of inpatient admissions. Leverage your expertise to ensure compliance, support appeals, and enhance q...

United StatesRemote

3 weeks ago

  •   5 - 7 years exp.  •   Healthcare

$64K - $96K *

Engage in comprehensive risk adjustment audits and compliance reviews, ensuring accurate data submission to CMS. Collaborate with coding teams and management to uphold regulatory standards and improve...

United StatesRemote

Reposted 1 week ago

  •   Less than 5 years exp.  •   Healthcare

$81K - $153K *

Champion financial examinations by leading teams to ensure quality, compliance, and timely delivery of regulatory services. Foster client relationships, manage complex projects, and drive growth in a...

United StatesRemote

Reposted 1 week ago

  •   8 - 10 years exp.  •   Finance & Insurance

$80K - $95K *

Join a team that's dedicated to enhancing healthcare quality through thorough medical claims audits. Leverage your nursing expertise in a dynamic remote environment, collaborating with experienced aud...

United StatesRemote

2 weeks ago

  •   5 - 7 years exp.  •   Information Technology

$135K - $237K *

Join a team that fosters financial leadership and strategic excellence by providing key support to market leaders, ensuring transparent reporting, and driving business success through collaboration an...

New York, NYRemote

Reposted 2 weeks ago

  •   5 - 7 years exp.  •   Healthcare

$100K - $115K *

Drive impactful change by leading Medicaid initiatives that enhance community health. Collaborate with state agencies, utilize your expertise in Medicaid policies, and advance your career in a support...

United StatesRemote

4 weeks ago

  •   5 - 7 years exp.  •   Legal & Accounting

$100K - $300K *

Lead complex analytical initiatives by developing data solutions and dashboards that drive business insights. Collaborate with stakeholders to translate requirements into scalable analytical framework...

United StatesRemote

3 days ago

  •   5 - 7 years exp.  •   Finance & Insurance

$85K - $95K *

Transform processes and drive accountability by leading cross-functional projects. Manage initiatives from scoping to completion while maintaining clear communication across teams and ensuring stakeho...

United StatesRemote

4 weeks ago

  •   Less than 5 years exp.  •   Finance & Insurance

$80K - $113K *

Join a team that's driving operational excellence in professional billing for Oncology and Acute Medicine. Lead a dedicated team, enhance revenue cycle performance, and ensure compliance while fosteri...

Chicago, ILRemote

3 days ago

  •   5 - 7 years exp.  •   Business Services

$106K - $167K *

Champion risk management strategies by overseeing domestic and international insurance programs, negotiating terms, and ensuring compliance. Collaborate with stakeholders to analyze risks and optimize...

Ohio, USRemote

3 weeks ago

  •   8 - 10 years exp.  •   Healthcare

$108K - $196K *

Shape the future of healthcare by managing client relationships and optimizing clinical programs. Collaborate with teams to drive client success and ensure alignment with company goals, leveraging dat...

United StatesRemote

4 weeks ago

  •   Less than 5 years exp.  •   Healthcare

Frequently Asked Questions (FAQ)

  • What does a Claims Specialist do?question toggle

    A Claims Specialist reviews and investigates claims, evaluates coverage and supporting information, documents findings, and helps determine appropriate resolutions or payments. Duties depend on the employer and claims specialty.

  • What qualifications are commonly required for Claims Specialist jobs?question toggle

    Requirements vary, but employers often value claims or insurance experience, analytical and communication skills, attention to detail, and familiarity with relevant policies and systems. Some roles may require licenses, certifications, or specialized industry knowledge.

  • Which industries hire Claims Specialists?question toggle

    Claims Specialists work in insurance and may also support healthcare, workers’ compensation, employee benefits, and other organizations that process claims.

  • Can I find Claims Specialist jobs paying $100,000 or more on Ladders?question toggle

    Yes. Ladders features vetted professional jobs paying $100,000 or more, including Claims Specialist opportunities when available.