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Claim Processor Jobs in Ohio (NOW HIRING)

Forhyre

OH · On-site

Responsibilities * Assist in the development of key performance indicators related to claim processing and call center performance * Use existing technology to automate work distribution, create and ...

AVA Consulting

Medical Claims Coordinator/Processor

Mason, OH · On-site

$17 - $22.50/hr

Review open/unpaid claim balances and take required action. Major Duties & Responsibilities: * Review medical claims and transmit to the insurance carrier using the practice electronic health records ...

Trak Group

Claims Specialist

Blue Ash, OH

This role is responsible for reviewing claim documentation, calculating claim benefits, processing payments, maintaining accurate records, and ensuring compliance with policy provisions and ...

VIVA USA INC

Claims Coordinator

Mason, OH · On-site

Also performs other complex claim processing which include but not limited to Medicare/Medicaid Pend process, Corrected Claims, and running daily reports. MAJOR DUTIES AND RESPONSIBILITIES ...

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Claim Processor information

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$11

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How much do claim processor jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for claim processor in Ohio is $18.22, according to ZipRecruiter salary data. Most workers in this role earn between $15.53 and $19.66 per hour, depending on experience, location, and employer.

What is a claim processor?

A Claim Processor is a professional who reviews and handles insurance claims submitted by policyholders or healthcare providers. Their main responsibilities include verifying the accuracy of claim information, ensuring all required documentation is provided, and determining whether a claim is valid under the policy terms. Claim Processors work with various types of insurance, such as health, auto, or property, and play a crucial role in ensuring timely and accurate payments. They may also communicate with customers, providers, and adjusters to resolve any discrepancies or additional information requests.

What are some typical challenges a claim processor might face in their daily work?

Claim Processors often handle high volumes of paperwork and data entry, which can be challenging when ensuring accuracy and meeting tight deadlines. They may also need to interpret complex policy details or resolve discrepancies in submitted claims, requiring strong attention to detail and problem-solving skills. Additionally, Claim Processors frequently interact with policyholders, healthcare providers, or other internal teams, so effective communication and the ability to manage stressful situations professionally are important for success.

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

To thrive as a Claim Processor, you need strong attention to detail, analytical skills, and a basic understanding of insurance policies, usually supported by a high school diploma or equivalent. Familiarity with claims management software, data entry systems, and sometimes certification such as AIC (Associate in Claims) is common. Excellent organizational skills, clear communication, and the ability to handle sensitive information with discretion help individuals excel in this role. These skills ensure accurate and timely processing of claims, minimize errors, and maintain customer satisfaction and regulatory compliance.

What is the difference between Claim Processor vs Claims Examiner?

AspectClaim ProcessorClaims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require insurance certificationsHigh school diploma; insurance certifications preferred
Work EnvironmentOffice settings, insurance companies, healthcare providersOffice settings, insurance companies, healthcare providers
Employer & Industry UsageInsurance companies, healthcare providers, third-party administratorsInsurance companies, third-party administrators, government agencies
Job FocusProcessing insurance claims, data entry, verifying informationReviewing claims for accuracy, compliance, and coverage decisions

While both Claim Processors and Claims Examiners work within the insurance industry handling claims, Claim Processors primarily focus on data entry and initial processing of claims. Claims Examiners review claims for accuracy and compliance, making decisions on claim approval or denial. The roles often overlap, but Claims Examiners typically require more experience or certifications and perform more in-depth analysis.

Is claim processing hard?

Claim processing is a detail-oriented job that requires strong organizational skills, attention to accuracy, and familiarity with insurance policies and claims systems. While it can involve repetitive tasks, many claim processors find it manageable with proper training and experience. The difficulty level varies depending on the complexity of claims and the work environment.

What do you need to be a claim processor?

To be a claim processor, you typically need a high school diploma or equivalent, strong attention to detail, and good organizational skills. Familiarity with claims processing software and basic knowledge of insurance policies are also important. Some positions may require prior experience in customer service or administrative roles.

What is a claims processing job?

A claims processing job involves reviewing, verifying, and managing insurance claims to determine their validity and appropriate payout. Claim processors use specialized software and follow company policies to ensure accurate and timely processing of claims, often requiring attention to detail and knowledge of insurance policies.

What are the most commonly searched types of Claim Processor jobs in Ohio?

The most popular types of Claim Processor jobs in Ohio are:

What cities in Ohio are hiring for Claim Processor jobs?

Cities in Ohio with the most Claim Processor job openings:

Claim Processor jobs near you
Infographic showing various Claim Processor job openings in Ohio as of August 2026, with employment types broken down into 83% Full Time, 15% Part Time, and 2% Contract. Highlights an 81% Physical, 6% Hybrid, and 13% Remote job distribution, with an average salary of $37,898 per year, or $18.2 per hour.

Business Analyst - Pharma

OH • On-site

Forhyre
1 - 10 employees
Learn more about Forhyreexternal

Full-time

Re-posted 28 days ago

Job description

We are looking for a Claims Business Analyst who will be the vital link between our information technology capacity and our business objectives by supporting and ensuring the successful completion of analytical, building, testing and deployment tasks of our software product’s features.

This Claims Business Analyst works collaboratively with the Director of Claims in supporting the department to deliver timely and accurate payment of claims and first call resolution . This role will also provide analysis related to the identification of improved claim system configuration and call flows that would positively impact quality performance , reduce claim inventory and improve the customer experience.
 

Responsibilities

  • Assist in the development of key performance indicators related to claim processing and call center performance
  • Use existing technology to automate work distribution, create and maintain department metric dashboards
  • Generate and distribute weekly/monthly/quarterly departmental reports to management and staff
  • Summarizes, creates, and distributes operational , claim data , and call center metric reports as needed.
  • Ensures deliverables are completed on time; responds to changing project circumstances and communicates issues to project leadership.
  • Identify trends in data, including those that were not necessarily being activity monitored, which may have an impact on departmental performance and/or impact timeliness and the customer experience . Communicate actionable findings and provide recommendations as appropriate to management.
  • Work directly with managers and subject matter experts to refine and improve these tools for optimal efficiency and effectiveness.
  • Responsible for creating data definitions, validating data, retrieving data from systems, merging data from multiple sources, participating or reviewing technical documentation, report configuration, and coordinates project efforts as directed in order to achieve desired results. 
  • Serves as a liaison to other department s (IS, Utilization Management, Provider Contracting, Provider Data Maintenance) that may include report creation , disseminating reports and/or leading the implementation, maintenance, testing and/or functional design of system changes.

Requirements

  • Experience working with technology, systems and IS departments
  • Advance Microsoft Excel skilled
  • Knowledge of ICD-10 and CPT-4 coding and medical terminology
  • Proficient in Windows, Word, and Business Analytical tools
  • Must have strong analytical and problem-solving skills.
  • Strong communication skills, including an ability to communicate with staff at various levels, including both front line staff and senior management.
  • Must have excellent analytical, organizational, and interpersonal skills, as well as a strong background in pharmacy claims processing, and the managed care industry
  • Experience working within the Payer / PBM market (in particular Medicare and Medicaid, Part D and its components) with understanding of benefit plan structures, NCPDP standards, HIPAA regulations, and other pharmacy products and services
  • Must understand the work flow of pharmacy claim processing or related Med D functions. For example, Enrollment, Drug Utilization
  • Review, Adjudication, Pricing, Payments/Billing, EOB, PDE, FIR, Reprocessing, or other features resident in or working in cooperation with a pharmacy benefit system
  • Strong business knowledge of Pharmacy Benefit Systems and Drug benefit plan administration with exposure to COTS / custom applications would be an advantage
  • Ability to effectively present information and respond to questions from clients, management and technical associates
  • Collaborate across the entire product team to ensure product dependencies, goals and experiences are defined and met
  • Document business requirements and user journeys
  • Must have agile project execution experience along with familiarity to scrum tools and methodologies 
  • Should have excellent verbal, written, documentation and presentation skills

Note: U.S. citizens and those authorized to work in the U.S. are encouraged to apply. We are unable to sponsor at this time.