Find The Best Claims Adjudicator Jobs For You

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Average Salary
$39,738
Average Salary
Job Growth Rate
-4%
Job Growth Rate
Job Openings
6,579
Job Openings

Claims Adjudicator Careers

Claims adjudication is the process of paying or denying claims after they are evaluated. Claims adjudicators are the ones responsible for determining the amount of money that should be paid to the insurance policy owners, as well as deciding if the claim should be denied or negotiated.

The typical workflow of a claims adjudicator involves many reviews, namely the initial process review, automatic review, and manual review, which are then followed by payment determination and the payment itself. During this process, a claims adjudicator examines claim documents, investigates the claim, and reviews the policy of the insured before making a decision.

Typically, you need to have a bachelor's degree in accounting, human resources, or a similar field in order to qualify for this role. You may also need to have specialized training or experience in a specific area, such as in the case of health insurance claims adjudicators. Nevertheless, employers may hire fresh graduates for this entry-level role, given that they have excellent communication and analytical skills.

There is more than meets the eye when it comes to being a claims adjudicator. For example, did you know that they make an average of $19.1 an hour? That's $39,738 a year!

Between 2018 and 2028, the career is expected to grow -4% and produce -13,000 job opportunities across the U.S.

What Does a Claims Adjudicator Do

There are certain skills that many claims adjudicators have in order to accomplish their responsibilities. By taking a look through resumes, we were able to narrow down the most common skills for a person in this position. We discovered that a lot of resumes listed communication skills, math skills and analytical skills.

When it comes to the most important skills required to be a claims adjudicator, we found that a lot of resumes listed 14.2% of claims adjudicators included medical records, while 7.8% of resumes included cpt, and 6.9% of resumes included disability claims. Hard skills like these are helpful to have when it comes to performing essential job responsibilities.

When it comes to searching for a job, many search for a key term or phrase. Instead, it might be more helpful to search by industry, as you might be missing jobs that you never thought about in industries that you didn't even think offered positions related to the claims adjudicator job title. But what industry to start with? Most claims adjudicators actually find jobs in the health care and insurance industries.

How To Become a Claims Adjudicator

If you're interested in becoming a claims adjudicator, one of the first things to consider is how much education you need. We've determined that 50.3% of claims adjudicators have a bachelor's degree. In terms of higher education levels, we found that 6.1% of claims adjudicators have master's degrees. Even though most claims adjudicators have a college degree, it's possible to become one with only a high school degree or GED.

Choosing the right major is always an important step when researching how to become a claims adjudicator. When we researched the most common majors for a claims adjudicator, we found that they most commonly earn bachelor's degree degrees or associate degree degrees. Other degrees that we often see on claims adjudicator resumes include high school diploma degrees or master's degree degrees.

You may find that experience in other jobs will help you become a claims adjudicator. In fact, many claims adjudicator jobs require experience in a role such as customer service representative. Meanwhile, many claims adjudicators also have previous career experience in roles such as claim processor or sales associate.

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Average Salary
$39,738
Average Salary
Job Growth Rate
-4%
Job Growth Rate
Job Openings
6,579
Job Openings

Claims Adjudicator Career Paths

Top Careers Before Claims Adjudicator

Top Careers After Claims Adjudicator

Claims Adjudicator Jobs You Might Like

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Tell us your goals and we'll match you with the rights job to get there.

Average Salary for a Claims Adjudicator

Claims Adjudicators in America make an average salary of $39,738 per year or $19 per hour. The top 10 percent makes over $47,000 per year, while the bottom 10 percent under $33,000 per year.
Average Salary
$39,738
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Best Paying Cities

City
ascdesc
Average Salarydesc
Columbus, OH
Salary Range31k - 45k$37k$37,468
Little Rock, AR
Salary Range27k - 39k$33k$33,065
$27k
$45k

Recently Added Salaries

Job TitleCompanyascdescCompanyascdescStart DateascdescSalaryascdesc
Disability Claims Adjudicator
Disability Claims Adjudicator
State of Maine, Bureau of Human Resources
State of Maine, Bureau of Human Resources
06/16/2021
06/16/2021
$42,55706/16/2021
$42,557
Ddssa Claims Adjudicator I
Ddssa Claims Adjudicator I
Disability Determ/SSA
Disability Determ/SSA
05/30/2021
05/30/2021
$40,00005/30/2021
$40,000
Ddssa Claims Adjudicator I
Ddssa Claims Adjudicator I
State of Arkansas
State of Arkansas
05/19/2021
05/19/2021
$36,15505/19/2021
$36,155
Ddssa Claims Adjudicator I
Ddssa Claims Adjudicator I
Arkansas Government Job
Arkansas Government Job
05/19/2021
05/19/2021
$36,15505/19/2021
$36,155
Ddssa Claims Adjudicator I
Ddssa Claims Adjudicator I
State of Arkansas
State of Arkansas
05/19/2021
05/19/2021
$36,15505/19/2021
$36,155
See More Recent Salaries

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Claims Adjudicator Demographics

Gender

female

73.3 %

male

22.1 %

unknown

4.6 %

Ethnicity

White

67.0 %

Hispanic or Latino

13.5 %

Black or African American

10.4 %

Foreign Languages Spoken

Spanish

61.9 %

German

14.3 %

French

9.5 %
See More Demographics

Claims Adjudicator Education

Majors

Business
22.7 %

Degrees

Bachelors

50.3 %

Certificate

15.7 %

Associate

14.9 %

Top Colleges for Claims Adjudicators

1. Stanford University

Stanford, CA • Private

In-State Tuition
$51,354
Enrollment
7,083

2. University of Pennsylvania

Philadelphia, PA • Private

In-State Tuition
$55,584
Enrollment
10,764

3. Northwestern University

Evanston, IL • Private

In-State Tuition
$54,568
Enrollment
8,451

4. California State University - Bakersfield

Bakersfield, CA • Private

In-State Tuition
$7,309
Enrollment
9,142

5. University of Southern California

Los Angeles, CA • Private

In-State Tuition
$56,225
Enrollment
19,548

6. SUNY Stony Brook

Stony Brook, NY • Private

In-State Tuition
$9,625
Enrollment
17,407

7. Boston University

Boston, MA • Private

In-State Tuition
$53,948
Enrollment
17,238

8. New York University

New York, NY • Private

In-State Tuition
$51,828
Enrollment
26,339

9. Maria College of Albany

Albany, NY • Private

In-State Tuition
$15,140
Enrollment
876

10. University of Minnesota - Twin Cities

Minneapolis, MN • Private

In-State Tuition
$14,760
Enrollment
31,451
See More Education Info

Online Courses For Claims Adjudicator That You May Like

Medical Coding: ICD-10-CM Diagnosis Code Training
udemy
3.9
(543)

Learn medical coding and prepare yourself for today's healthcare workplace...

Contracts, Delays and Claims with Primavera P6
udemy
4.2
(471)

Learn all about Contracts, Delays & Claims along with practical Delay Analysis using Primavera P6 software...

Data Analytics and Visualization in Health Care
edX (Global)

Big data is transforming the health care industry relative to improving quality of care and reducing costs--key objectives for most organizations. Employers are desperately searching for professionals who have the ability to extract, analyze, and interpret data from patient health records, insurance claims, financial records, and more to tell a compelling and actionable story using health care data analytics. The course begins with a study of key components of the U.S. health care system as...

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Top Skills For a Claims Adjudicator

The skills section on your resume can be almost as important as the experience section, so you want it to be an accurate portrayal of what you can do. Luckily, we've found all of the skills you'll need so even if you don't have these skills yet, you know what you need to work on. Out of all the resumes we looked through, 14.2% of claims adjudicators listed medical records on their resume, but soft skills such as communication skills and math skills are important as well.

Best States For a Claims Adjudicator

Some places are better than others when it comes to starting a career as a claims adjudicator. The best states for people in this position are Rhode Island, Connecticut, New Hampshire, and New Jersey. Claims adjudicators make the most in Rhode Island with an average salary of $51,554. Whereas in Connecticut and New Hampshire, they would average $51,070 and $50,219, respectively. While claims adjudicators would only make an average of $49,416 in New Jersey, you would still make more there than in the rest of the country. We determined these as the best states based on job availability and pay. By finding the median salary, cost of living, and using the Bureau of Labor Statistics' Location Quotient, we narrowed down our list of states to these four.

1. Connecticut

Total Claims Adjudicator Jobs:
53
Highest 10% Earn:
$74,000
Location Quotient:
1.28
Location Quotient is a measure used by the Bureau of Labor Statistics (BLS) to determine how concentrated a certain industry is in a single state compared to the nation as a whole. You can read more about how BLS calculates location quotients here

2. New Jersey

Total Claims Adjudicator Jobs:
133
Highest 10% Earn:
$72,000
Location Quotient:
1.34
Location Quotient is a measure used by the Bureau of Labor Statistics (BLS) to determine how concentrated a certain industry is in a single state compared to the nation as a whole. You can read more about how BLS calculates location quotients here

3. Nevada

Total Claims Adjudicator Jobs:
33
Highest 10% Earn:
$63,000
Location Quotient:
1.26
Location Quotient is a measure used by the Bureau of Labor Statistics (BLS) to determine how concentrated a certain industry is in a single state compared to the nation as a whole. You can read more about how BLS calculates location quotients here
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Top Claims Adjudicator Employers

1. Indiana Government
4.3
Avg. Salary: 
$43,129
Claims Adjudicators Hired: 
15+
2. Independent Health
4.6
Avg. Salary: 
$39,857
Claims Adjudicators Hired: 
14+
3. Blue Cross Blue Shield of Michigan
4.7
Avg. Salary: 
$40,828
Claims Adjudicators Hired: 
14+
4. Blue Cross and Blue Shield of Texas
4.5
Avg. Salary: 
$39,850
Claims Adjudicators Hired: 
13+
5. Social Security Administration
4.6
Avg. Salary: 
$34,852
Claims Adjudicators Hired: 
12+
6. Philidor Rx Services
3.9
Avg. Salary: 
$43,197
Claims Adjudicators Hired: 
11+

Claims Adjudicator Videos

Updated October 2, 2020