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Claim Processing Specialist Jobs (NOW HIRING)

Integrated Resources INC

Claims analyst

Omaha, NE

... to claim processing issues. Routes and triages complex claims to Senior Claim Benefits Specialist. (*) Proofs claim or referral submission to determine, review, or apply appropriate guidelines ...

Addison Group

Billing Specialist

Philadelphia, PA · On-site

$20 - $23/hr

They are seeking a Billing Specialist to join their Revenue Cycle team to support claim processing, payment posting, and denial resolution while ensuring timely and accurate reimbursement. The ...

Addison Group

Billing Specialist

Philadelphia, PA · On-site

$20 - $23/hr

They are seeking a Billing Specialist to join their Revenue Cycle team to support claim processing, payment posting, and denial resolution while ensuring timely and accurate reimbursement. The ...

Ascent Health LLC

Data Entry Specialist

Breckenridge, CO · On-site

$24.04/hr

Position Overview The Revenue Cycle Management Specialist (RCMS) supports the financial health of the company by ensuring the fulfillment of targeted claim processing and revenue capture benchmarks.

State of Maryland

Benefits Processing

Baltimore, MD · On-site

$52K - $56K/yr

... Specialist III in the Deceased Processing Unit. The incumbent reports to the Death Benefits ... Prepare and mail follow-up claim packets per established procedures. • Incoming correspondence ...

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Claim Processing Specialist information

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How much do claim processing specialist jobs pay per hour?

As of Aug 4, 2026, the average hourly pay for claim processing specialist in the United States is $18.99, according to ZipRecruiter salary data. Most workers in this role earn between $17.79 and $20.19 per hour, depending on experience, location, and employer.

What is the difference between Claim Processing Specialist vs Claims Adjuster?

AspectClaim Processing SpecialistClaims Adjuster
CredentialsHigh school diploma or equivalent; some roles may require insurance certificationsHigh school diploma; licensing or certification often required
Work EnvironmentOffice setting, processing claims, data entryField or office, investigating claims, assessing damages
Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusters
Primary FocusProcessing and verifying insurance claimsEvaluating damages and determining claim validity

While both roles work within the insurance industry, a Claim Processing Specialist primarily handles the administrative task of processing claims, whereas a Claims Adjuster evaluates damages and determines claim validity. The roles often overlap but differ in responsibilities and required certifications.

What does a claim processing specialist do?

A Claim Processing Specialist is responsible for reviewing, evaluating, and processing insurance claims submitted by policyholders. They verify the accuracy of information, ensure all required documentation is included, and determine if the claim meets policy guidelines. Claim Processing Specialists may communicate with claimants, healthcare providers, or other relevant parties to gather additional information. Their main goal is to ensure that claims are processed efficiently, accurately, and in compliance with company and regulatory standards.

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

To thrive as a Claim Processing Specialist, you need strong analytical skills, attention to detail, and a foundational understanding of insurance policies, typically supported by a high school diploma or associate degree. Familiarity with claims management software, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are commonly required. Excellent organizational skills, effective communication, and customer service orientation set top performers apart. These abilities ensure accurate, timely claim assessments and foster positive client experiences, which are critical for efficient insurance operations.

What are some common challenges faced by claim processing specialists, and how are they typically addressed within a team environment?

Claim Processing Specialists often encounter challenges such as high volumes of claims, tight deadlines, and complex case details that require careful review. These challenges are usually addressed through strong team collaboration, clear communication with other departments (like underwriting and customer service), and ongoing training on new policies and technology updates. Many organizations also implement workflow management tools and peer review processes to ensure accuracy and efficiency, making it easier for specialists to manage workloads and maintain high standards.
What cities are hiring for Claim Processing Specialist jobs? Cities with the most Claim Processing Specialist job openings:
What states have the most Claim Processing Specialist jobs? States with the most job openings for Claim Processing Specialist jobs include:
Claim Processing Specialist jobs near you
Infographic showing various Claim Processing Specialist job openings in the United States as of July 2026, with employment types broken down into 80% Full Time, 19% Part Time, and 1% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $39,500 per year, or $19 per hour.

Claims Processing Specialist - Tarentum, PA

BLACKBURNS PHYSICIANS PHARMACY INC

Tarentum, PA • On-site

Other

Medical, Retirement, PTO

Re-posted 20 days ago

Job description

Blackburn's Physicians Pharmacy, Inc. Tarentum, PA
Full-Time Monday-Friday Daylight Schedule
Help Patients Access the Care They Need
At Blackburn's Physicians Pharmacy, Inc., we believe access to healthcare starts long before a patient receives their equipment. Every authorization secured, every claim processed, and every reimbursement resolved helps ensure patients receive the medical equipment and services they depend on.
We're looking for a detail-oriented, organized, and motivated Claims Processing Specialist to join our growing Claims Department in Tarentum. If you thrive in a fast-paced healthcare environment, enjoy problem-solving, and take pride in accuracy, this is an opportunity to build a rewarding career while making a meaningful impact on patient care.
What You'll Do
  • Review, process, and monitor medical insurance claims for accuracy, completeness, and compliance with payer guidelines.
  • Verify insurance benefits, authorization requirements, and documentation needed for claim submission.
  • Manage authorizations, reauthorizations, and prescription renewals to support uninterrupted patient care.
  • Monitor outstanding claims, investigate denials, and perform timely follow-up with insurance carriers and providers.
  • Communicate with insurance representatives to resolve claim issues, missing documentation, and reimbursement questions.
  • Maintain accurate account notes, claim documentation, and audit-ready records within company systems.
  • Utilize work queues and reporting tools to prioritize workloads and meet filing deadlines.
  • Collaborate with billing, customer service, clinical teams, and referral sources to resolve claims efficiently.
  • Identify recurring reimbursement issues and recommend process improvements to reduce denials and improve operational efficiency.
What We're Looking For
  • Strong attention to detail with exceptional organizational and time management skills.
  • Excellent analytical, problem-solving, and critical-thinking abilities.
  • Strong verbal and written communication skills.
  • Ability to manage multiple priorities while meeting deadlines in a fast-paced environment.
  • Proficiency with computers, data entry, and Microsoft Office applications.
  • Collaborative mindset with the ability to work independently and across multiple departments.
  • Previous experience in healthcare claims processing, medical billing, insurance verification, or prior authorizations preferred.
  • Knowledge of Medicare, Medicaid, commercial insurance, or the DME/HME industry is highly preferred.
Why Join Blackburn's?
  • Monday-Friday daytime schedule with evenings and weekends off.
  • Competitive pay and comprehensive benefits package.
  • Paid time off and paid holidays.
  • 401(k) with profit sharing.
  • Hands-on training and ongoing professional development opportunities.
  • Supportive leadership and a collaborative team environment.
  • Career growth opportunities within a growing healthcare organization.
  • Join a respected, family-owned healthcare company serving our communities for nearly 90 years.
Make an Impact Every Day
Behind every successfully processed claim is a patient receiving the care and equipment they need. As a Claims Processing Specialist, your work helps remove barriers to care, supports timely reimbursement, and ensures patients receive the essential medical equipment that improves their quality of life.
If you're looking for a career where your attention to detail, problem-solving skills, and dedication make a real difference, apply today and become part of the Blackburn's team.
  • Previous experience in healthcare billing, claims processing, DME/HME, or insurance coordination preferred
  • Understanding of Medicare, Medicaid, and commercial insurance processes is a must
  • Strong attention to detail and problem-solving skills
  • Excellent communication and organizational abilities
  • Ability to work independently and as part of a team
  • Comfortable working in a high-volume, deadline-driven environment
  • Basic proficiency with Microsoft Office and computer-based systems

Apply