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Claim Operations Specialist Jobs (NOW HIRING)

Nimble Solutions

Billing Operations Specialist

New Hyde Park, NY · On-site

$20.50 - $27.50/hr

Under the direction of the Billing Manager, this role will be instrumental in ensuring timely claim ... The Billing Operations Specialist is responsible for managing and executing the day-to-day billing ...

Nimble Solutions

Billing Operations Specialist

New Hyde Park, NY · On-site

$20.50 - $27.50/hr

Under the direction of the Billing Manager, this role will be instrumental in ensuring timely claim ... The Billing Operations Specialist is responsible for managing and executing the day-to-day billing ...

Lyft

Senior Claims Operations Specialist

Nashville, TN · On-site

The Operations Specialist position is an integral role assisting with the processing of claims and ... Manages and coordinates next steps for Accidents; including missing claim searches, adjuster ...

New

Clenera, LLC

Sr. Operations Specialist

Boise, ID

ABOUT THE ROLE The Sr. Operations Specialist leads the performance, reliability, and operational ... Administer equipment warranty programs, including claim coordination, vendor communication ...

Clēnera, LLC

Sr. Operations Specialist

Boise, ID · On-site

ABOUT THE ROLE The Sr. Operations Specialist leads the performance, reliability, and operational ... Administer equipment warranty programs, including claim coordination, vendor communication ...

Lucyrx

Client Operations Specialist

The Client Operations Specialist provides administrative support for client pharmacy benefit ... Convert past claim files into proper format for bulk override entries * Review sample member cards ...

LucyRx

Client Operations Specialist

The Client Operations Specialist provides administrative support for client pharmacy benefit ... Convert past claim files into proper format for bulk override entries * Review sample member cards ...

Revelyst

Legal Operations Specialist

Irvine, CA · On-site

$100K - $105K/yr

We are seeking a Legal Operations Specialist to support the Revelyst Legal team with contract ... Support insurance claim tracking, notices, and related records. * Assist with legal hold notices ...

Extend

Fraud Operations Specialist I

$50K - $63K/yr

About the Role: As a Fraud Operations Specialist, you will join a growing Fraud Ops team and ... Real-Time Claim Review: Review claims in real time for potential cases of fraud/abuse, leveraging ...

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All JobsFinance and Insurance JobsInsurance JobsInsurance Claims Specialist JobsClaim Operations Specialist Jobs

Claim Operations Specialist information

See salary details

$30.5K

$68.4K

$111K

How much do claim operations specialist jobs pay per year?

As of Aug 22, 2026, the average yearly pay for claim operations specialist in the United States is $68,426.00, according to ZipRecruiter salary data. Most workers in this role earn between $48,000.00 and $81,500.00 per year, depending on experience, location, and employer.

What is a claim operations specialist?

Claim Operations Specialists are professionals who handle the administrative and procedural aspects of insurance claims. They review incoming claims for accuracy, process documentation, ensure compliance with company policies, and support the claims team by communicating with clients and other departments. Their role is crucial in ensuring that claims are managed efficiently and resolved in a timely manner. They often use specialized software and must pay close attention to detail to avoid errors. Additionally, they may assist in fraud detection and quality assurance within the claims process.

What are the key skills and qualifications needed to thrive as a claim operations specialist?

To thrive as a Claim Operations Specialist, you need attention to detail, strong organizational abilities, and a solid understanding of insurance policies and claims processes, typically supported by a bachelor's degree or relevant experience. Familiarity with claims management software, data entry systems, and sometimes industry certifications like AIC (Associate in Claims) are commonly required. Excellent communication, problem-solving skills, and the ability to manage multiple tasks efficiently make someone stand out in this position. These competencies are crucial for ensuring accurate claim processing, effective customer service, and maintaining compliance with regulatory standards.

What are some common challenges faced by claim operations specialists, and how can they be managed effectively?

Claim Operations Specialists often encounter challenges such as handling high volumes of claims, ensuring accuracy under tight deadlines, and navigating complex insurance policies. Successfully managing these challenges requires strong organizational skills, attention to detail, and effective communication with both internal teams and external parties. Utilizing workflow management tools and collaborating closely with adjusters and customer service representatives can help streamline processes and reduce errors, making the work both manageable and rewarding.

What is the difference between Claim Operations Specialist vs Claims Analyst?

Claim Operations SpecialistClaims Analyst
Focuses on managing claim processes, ensuring compliance, and coordinating between departmentsAnalyzes claim data, investigates claims, and assesses claim validity
Requires knowledge of claims procedures, customer service skills, and insurance policiesRequires analytical skills, attention to detail, and understanding of insurance policies
Works primarily in claims processing departments within insurance companiesWorks in data analysis, underwriting, or claims review teams

While both roles involve claims, the Claim Operations Specialist manages the overall claim process and ensures smooth operations, whereas the Claims Analyst focuses on analyzing claim data and making determinations about claim validity. Both roles require insurance knowledge and attention to detail but serve different functions within the claims lifecycle.

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What cities are hiring for Claim Operations Specialist jobs?

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What job categories do people searching Claim Operations Specialist jobs look for?

The top searched job categories for Claim Operations Specialist jobs are:

Claim Operations Specialist jobs near you
Infographic showing various Claim Operations Specialist job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $68,426 per year, or $32.9 per hour.

Billing Operations Specialist

Nimble Solutions

New Hyde Park, NY • On-site

$20.50 - $27.50/hr

Full-time

Re-posted 24 days ago

Job description

Description:


Why you’ll want to work at nimble!


This is a great opportunity to join a well-established and market-leading brand serving a high-growth end market while gaining valuable experience working closely with Executive leadership. As an organization, we are in high-growth mode through acquisition with a laser focus on positive culture building!


Who we are:


nimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers (ASCs), surgical clinics, surgical hospitals, and anesthesia groups. Our tech-enabled solutions allow surgical organizations to streamline their revenue cycle processes, reduce administrative burden, and improve financial outcomes. Join more than 1,100 surgical organizations that trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue cycle.


We are currently seeking a Billing Operations Specialist with a great work ethic to manage and execute the daily billing activities of the department. Under the direction of the Billing Manager, this role will be instrumental in ensuring timely claim submission, following up with payers, and handling billing discrepancies. The ideal candidate will have exceptional communication and organizational skills along with a strong attention to detail. We are looking for candidates who have experience working in a medical environment with great customer service skills and motivation to learn.


Job Summary:


The Billing Operations Specialist is responsible for managing and executing the day-to-day billing activities to ensure accurate invoicing (patient invoicing) and follow up with clients and patients. This role works closely with internal departments and external stakeholders to resolve billing discrepancies, optimize revenue capture, and maintain compliance with relevant regulations and payer requirements.

Key Responsibilities:

  • Post write-offs in the billing system as appropriate
  • Collaborate with coding, collections, and accounts receivable teams to support seamless revenue cycle processes
  • Respond to billing inquiries from clients, patients, or insurance companies in a timely and professional manner
  • Assist in the implementation of new billing processes, systems, or software upgrades
  • Submit invoices to patients
  • Manage patient outstanding balances
  • Generate and mail patient statements
  • Set up patient payment plans
  • Maintain accurate patient demographic and insurance information
Requirements:

Education & Experience:

  • High school diploma or equivalent
  • 2+ years of experience in medical or corporate billing, revenue cycle, or accounts receivable roles
  • Familiarity with insurance billing guidelines, CPT/ICD-10 codes, and electronic health record (EHR)/practice management systems (e.g., Epic, Athena, Cerner)

Skills & Competencies:

  • Strong analytical and problem-solving abilities
  • Proficient in Microsoft Office Suite (Excel, Outlook, Word
  • Excellent attention to detail and organizational skills
  • Strong written and verbal communication
  • Ability to multitask and work independently in a fast-paced environment
  • Knowledge of HIPAA and regulatory billing requirements