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Claim Department Jobs (NOW HIRING)

AmTrust Financial Services, Inc.

$100K - $155K/yr

Works with the Claim Department and Litigation Department on special projects related to the practice or line of business as needed. * Communicates with the Court, witnesses, opposing counsel and ...

AmTrust Financial Services, Inc.

$100K - $155K/yr

Works with the Claim Department and Litigation Department on special projects related to the practice or line of business as needed. * Communicates with the Court, witnesses, opposing counsel and ...

Principal Financial Group

Claim Analyst 2

Des Moines, IA · On-site +1

$27.12 - $36.35/hr

... Law Department as needed. * Communicate with customers in a professional, timely, and helpful ... Ensure claim payments are processed accurately and in a timely manner by following internal ...

US Xpress

Maintenance Manager

Springfield, OH

Participate in accident review with claim department and provide follow-up with appropriate vendors. Maintain appropriate parts and tire inventory to ensure efficient, cost effective maintenance and ...

Chubb

Casualty SIU Investigator

New York, NY

Claim Department, Claim Operations, Loss Control Department, Underwriting Departments, Agents Counsel, Insured's and/or their Legal Representatives, National Fraud Manager, Law Enforcement ...

U.S. Xpress

Maintenance Manager

Springfield, OH

Participate in accident review with claim department and provide follow-up with appropriate vendors. Maintain appropriate parts and tire inventory to ensure efficient, cost effective maintenance and ...

Barasch & McGarry

Claim Administrator

Manhattan, NY · On-site

$55K - $80K/yr

Collaborate with Supervisors, Attorneys, and other departments to ensure accurate and complete claim work. * Utilize CMS and other third-party portals while adhering to data-security and ...

Barasch and McGarry

Claim Administrator

Manhattan, NY · On-site

$55K - $80K/yr

Collaborate with Supervisors, Attorneys, and other departments to ensure accurate and complete claim work. * Utilize CMS and other third-party portals while adhering to data-security and ...

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How much do claim department jobs pay per hour?

As of Jun 29, 2026, the average hourly pay for claim department in the United States is $21.05, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $22.84 per hour, depending on experience, location, and employer.

What is a Claim Department?

A Claim Department is a division within an insurance company or organization responsible for processing and managing insurance claims. This department evaluates claims submitted by policyholders, determines the validity of each claim, and ensures that payment or service is provided according to the terms of the insurance policy. The Claim Department may also investigate claims for potential fraud and work with customers to resolve any disputes. Their goal is to provide fair and efficient service to both the company and its clients.

What are some common challenges faced by professionals working in a claim department, and how can they be managed?

Professionals in a claim department often deal with high volumes of cases, tight deadlines, and complex investigations that require attention to detail. Balancing efficiency with accuracy can be challenging, especially when handling sensitive customer information and making fair decisions. Effective time management, ongoing training, and strong communication skills are essential to manage these challenges. Collaborating closely with team members and leveraging claim management software can also help streamline workflows and reduce stress.

What are the key skills and qualifications needed to thrive in a Claim Department role, and why are they important?

To thrive in a Claim Department role, you need strong analytical abilities, attention to detail, and a background in insurance or finance, often supported by relevant education or certifications. Familiarity with claims management systems, insurance software, and regulatory compliance tools is typically required. Excellent communication, negotiation, and problem-solving skills help professionals effectively resolve claims and interact with policyholders. These capabilities ensure accurate claim processing, customer satisfaction, and adherence to legal and company standards.

What is the difference between Claim Department vs Claims Adjuster?

AspectClaim DepartmentClaims Adjuster
CredentialsVaries; often requires insurance knowledge, sometimes certificationsTypically requires licensing and certifications like state adjuster licenses
Work EnvironmentOffice setting, team-based, administrativeField or office-based, investigative and evaluative
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Search & Comparison IntentUnderstanding roles within insurance claims processingEvaluating claims, determining coverage and settlement

The Claim Department oversees the entire claims process within an insurance organization, managing multiple claims and coordinating teams. A Claims Adjuster focuses on investigating individual claims, assessing damages, and determining settlement amounts. While both roles require insurance knowledge and certifications, the Claim Department has a broader administrative scope, whereas the Claims Adjuster is more hands-on with claim evaluation.

More about Claim Department jobs
What job categories do people searching Claim Department jobs look for? The top searched job categories for Claim Department jobs are:
Claim Department jobs near you
Infographic showing various Claim Department job openings in the United States as of June 2026, with employment types broken down into 1% Locum Tenens, 1% Internship, 42% Full Time, 16% Part Time, and 40% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $43,783 per year, or $21 per hour.
Healthcare Customer Service Specialist

Healthcare Customer Service Specialist

Provider Network Solutions LLC

Miami, FL

$40K/yr

Other

Posted 27 days ago

Key responsibilities

  • Answer calls from providers to verify eligibility and provide claims payment status information.

  • Accurately document all communications from providers and create internal PDRs and open tickets according to organization policies and procedures.

  • Educate providers on the appeal and claim submission process and the use of the provider portal.

Job description

Description

Position Summary 


Customer Service Specialist is responsible for providing support to network providers, medical offices and billing companies. The customer service specialist will answer questions regarding eligibility, authorization, network guidelines, claims status and general health plan information. 


Duties and Responsibilities


Answer calls, from providers to verify eligibility and provide them with claims payment status. 

Search for members navigating through the TPA System and main health plan sites in order to check on member eligibility. 

Read and comprehend paid and denied claims and explain denial codes. 

Educate providers on the appeal/claim submission process and provider portal use.

Demonstrate professional etiquette and courtesy when interacting with providers.

Accurately and comprehensively documents all communications from providers based on organization policies and procedures through investigative research to create internal PDR's. internal open tickets.

Assist the Claim Department by entering appeals in the TPA System.

Assist the health plan by providing participating physicians information within the network per line of business (LOB). 

Assist the other customer service representatives on escalated issues.  

Support coverage for mailroom 

Support coverage for EDI Specialist

Process daily pending eligibility review for claims department workflow.

Generate provider letter weekly for rejected claim.

Generate and mail daily NABD & NDP letters.

Create refund letters and upload supporting documents in the claims processing system

Review deductibles and out of pockets accumulators' queue for claims department

Distribute faxes that are received daily to all departments. 

Performs other duties as assigned by Management.

Requirements

Knowledge


Specialty Network experience in Claims and/or Customer Service is required. 

Minimum of three (3) years of experience in the Healthcare industry.


Skills


Fluent in English and Spanish; oral and written communication. 

Microsoft (Outlook, Excel, Work, and PowerPoint).

Accurate Data Entry. 

Sales Skills.

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