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.
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.
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.
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.
Manager Professional Billing Coding Operations - Remote
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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...
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Clinical Research Associate II
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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...
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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...
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Senior National Account Manager, Personal Insurance
$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...
4 days ago
Senior Regulatory Affairs Specialist (Remote - United States)
$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...
1 week ago
$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...
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$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...
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Lead Technical Implementation Analyst
$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...
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$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...
2 days ago
Senior Revenue Cycle Analyst (Remote)
$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...
1 week ago
Senior Legal Counsel - Pharmacy Benefit Manager (PBM)
$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...
2 days ago
RN Case Manager Experienced (IKC-CA)
$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...
3 weeks ago
Payment Integrity Clinical Readmission Manager
$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...
3 weeks ago
Medicare Risk Adjustment Compliance Auditor (CPC, CCS, or CCS-P Required) (Remote)
$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...
Reposted 1 week ago
Financial Examiner Lead (Director/MD/Partner)
$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...
Reposted 1 week ago
Medical Review Nurse - CMS/RAC Auditor, Government Audits
$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...
2 weeks ago
Sr. Director, Market Chief Financial Officer (Must Live in New York)
$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...
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Senior Program and Policy Consultant-Medicaid
$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...
4 weeks ago
$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...
3 days ago
$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...
4 weeks ago
$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...
3 days ago
Manager, Global Risk Management
$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...
3 weeks ago
$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...
4 weeks ago
What does a Claims Specialist do?
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?
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?
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?
Yes. Ladders features vetted professional jobs paying $100,000 or more, including Claims Specialist opportunities when available.