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Claim Operator Jobs in Virginia (NOW HIRING)

Establish and maintain appropriate claim reserves based on investigation findings and projected ... Repetitive tasks associated with typing, note taking, telephonic communication and operating ...

Workers' Compensation Claims Associate

Roanoke, VA ยท On-site

$19.75 - $22.50/hr

In this role, you'll play a key part in managing claim details and delivering exceptional service. Metis is a Roanoke-owned and operated organization dedicated to providing innovative solutions ...

... and claim closure discipline. * Provide quarterly forecasts on claims expenditures and recoveries * Drive improvements in experience modification outcomes across operating entities. Analytics ...

... claim closure discipline. Provide quarterly forecasts on claims expenditures and recoveries Drive improvements in experience modification outcomes across operating entities. Analytics, Reporting ...

Pharmacy Medical Secretary (31765)

Woodbridge, VA ยท On-site

$18.75 - $22.75/hr

Compounds: payment collection, claim creation, ecw documentation, and order placement through ... Skill in operating office equipment. * Skill in organizational matters, including time management ...

Process prescription exceptions, including resolving claim rejects and conducting outreach to ... Follow all pharmacy regulations, internal policies, and standard operating procedures to maintain ...

Process prescription exceptions, including resolving claim rejects and conducting outreach to ... Follow all pharmacy regulations, internal policies, and standard operating procedures to maintain ...

Showing results 21-40

Claim Operator information

What are some common challenges a claim operator faces in managing insurance claims, and how can they be addressed?

Claim Operators often encounter challenges such as handling a high volume of claims, ensuring accuracy in documentation, and meeting strict deadlines. These challenges can be managed by developing strong organizational skills, utilizing claims management software efficiently, and maintaining clear communication with both clients and team members. Staying updated on regulatory changes and company policies also helps prevent errors and ensures compliance throughout the claims process.

What is the difference between Claim Operator vs Claims Adjuster?

AspectClaim OperatorClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require insurance licensesHigh school diploma; licensing or certification often required
Work EnvironmentInsurance companies, claims processing centersFieldwork and office settings, inspecting damages
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Common Search & ComparisonClaim OperatorClaims Adjuster

Claim Operators primarily handle the administrative processing of claims within insurance companies, focusing on data entry and documentation. Claims Adjusters, on the other hand, evaluate damages, inspect claims, and determine settlement amounts. While both roles require insurance knowledge and sometimes licensing, Claim Operators focus on processing, whereas Claims Adjusters are more involved in assessment and decision-making.

What are the key skills and qualifications needed to thrive as a claim operator, and why are they important?

To thrive as a Claim Operator, you need strong analytical skills, attention to detail, and a foundational understanding of insurance processes, often supported by a high school diploma or equivalent. Familiarity with claims management software, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent communication, organization, and problem-solving abilities help in interacting with clients and resolving claims efficiently. These skills are crucial for accurately processing claims, ensuring customer satisfaction, and maintaining compliance with regulatory standards.

What does a claim operator do?

A Claim Operator is responsible for processing and managing insurance claims. They review claim submissions, verify documentation for accuracy, and determine the validity of claims according to company policies. Claim Operators may also communicate with clients, adjusters, and other stakeholders to gather additional information or resolve issues. Their role helps ensure that claims are handled efficiently and fairly, contributing to customer satisfaction and the integrity of the insurance process.

What cities in Virginia are hiring for Claim Operator jobs?

Cities in Virginia with the most Claim Operator job openings:

Infographic showing various Claim Operator job openings in Virginia as of August 2026, with employment types broken down into 52% Full Time, 46% Part Time, 1% Contract, and 1% Nights. Highlights an 99% Physical, and 1% Remote job distribution.

Property Adjuster (Inside)

Capstone ISG Inc

Midlothian, VA โ€ข On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 21 days ago


Job description

Description:

We are seeking a detail-oriented Property Claims Adjuster to independently manage residential and commercial property claims throughout the investigation, evaluation, and resolution process. This position requires strong technical claims handling skills, sound coverage analysis, accurate estimating capabilities, and the ability to manage multiple claims of varying severity and complexity.

The successful candidate will conduct field investigations, evaluate coverage, determine loss exposure, prepare estimates, negotiate settlements, and provide comprehensive reporting to clients while maintaining compliance with applicable regulations and industry standards.

This position is in office in Richmond, VAPrimary Responsibilities
  • Conduct field investigations involving residential and commercial property losses.
  • Analyze policy language, endorsements, coverage forms, exclusions, and client instructions to determine coverage applicability and claim exposure.
  • Evaluate and adjust property claims ranging from routine losses to complex, high-severity claims.
  • Document damage through photographs, measurements, interviews, and detailed field notes.
  • Prepare repair and replacement estimates utilizing Xactimate and other estimating resources.
  • Establish and maintain appropriate claim reserves based on investigation findings and projected exposure.
  • Prepare comprehensive reports, coverage analyses, settlement recommendations, and client communications.
  • Draft settlement letters, denial letters, Reservation of Rights letters, and other claim correspondence.
  • Conduct content inventory reviews and perform pricing analysis for personal property and business contents losses.
  • Identify and investigate subrogation opportunities and preserve recovery rights.
  • Retain and coordinate engineers, contractors, consultants, and other experts as necessary to evaluate causation, damages, and liability exposure.
  • Negotiate settlements within established authority and provide recommendations on complex claim resolutions.
  • Maintain accurate documentation, billing records, and expense reporting.
  • Manage assigned caseload while meeting quality, service, and reporting standards.
  • Maintain compliance with state regulations, carrier guidelines, and industry best practices.
  • Participate in continuing education and maintain all required adjuster licenses.



Requirements:


  • Requires a high school diploma; advanced education beyond high school preferred or an equivalent combination of education and experience.
  • Previous experience as a claims adjuster or must complete Capstone specified adjuster training if no experience.
  • If previous adjuster experience, working knowledge of Xactimate is preferred.
  • Must be licensed, or have the ability to obtain license(s), as required by state and local jurisdictions to adjust insurance claims.

Skills and Competencies:

  • Ability to work in a high volume, fast paced environment managing multiple tasks.
  • Ability to provide excellent service to policyholders and clients.
  • Ability to efficiently operate a computer and related claims and business software.
  • Effective analytical and problem-solving skills necessary to make decisions and resolve conflict
  • Good verbal and written communication skills.
  • Good attention to detail.
  • Strong analytical and mathematical ability.
  • Ability to work independently in a virtual environment when required.
  • Good organizational and time management skills.
Compensation & Benefits

We recognize that experienced claims professionals bring valuable technical expertise and industry knowledge. To support our team members both professionally and personally, we offer a competitive compensation and benefits package that includes:

  • Competitive salary with annual merit-based increases
  • Quarterly performance-based bonus opportunities
  • Comprehensive medical, dental, and vision insurance
  • 401(k) retirement savings plan
  • Company-paid life insurance
  • Short-term and long-term disability coverage
  • Paid vacation, sick leave, and company holidays
  • Fitness membership reimbursement program
  • Company-sponsored training and professional development opportunities
  • Ongoing support for continuing education and industry advancement

Physical Demand Requirements:

The physical requirements associated with the position are limited. Repetitive tasks associated with typing, note taking, telephonic communication and operating standard office equipment are required. Employees are required to work within a Capstone office unless otherwise directed by management.