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Claim Processor Jobs (NOW HIRING)

Winston Staffing Services

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Claim Specialist

Jericho, NY · On-site

$27 - $28/hr

Develop and implement process improvements to streamline claim workflows and reduce turnaround times. * Cross-Functional Collaboration: Collaborate with cross-functional teams to identify and resolve ...

Collabera

Claims Processor

Mason, OH

$16 - $20.25/hr

Claim Processor Duration: 3 Months (possible extension) Roles and Responsibilities: Accurately and efficiently processes manual claims and other simple processes such as matrix and bypass. Through ...

The MH Group, LLC

Manager Claim Processing

Hartford, CT · On-site

Oversee and manage daily operations of the claims processing department to ensure timely and accurate claim handling. * Develop, implement, and maintain quality control standards to ensure accuracy ...

The MH Group LLC

Manager Claim Processing

Hartford, CT · On-site

Oversee and manage daily operations of the claims processing department to ensure timely and accurate claim handling. * Develop, implement, and maintain quality control standards to ensure accuracy ...

Integrated Resources INC

Claims analyst

Omaha, NE

Omaha NE 68154 Duration: 12 months Family Summary/Mission Achieve superior claim and member service performance through an integrated process of operational, quality, medical cost, and resource ...

Allied Solutions

Claims Investigator

Plano, TX · On-site

This position will involve the initial processing and investigation of 20-40 claims per day. This position ensures that all claim documentation is thoroughly reviewed and assessed for coverage ...

Allied Solutions

Claims Investigator

Plano, TX · On-site

This position will involve the initial processing and investigation of 20-40 claims per day. This position ensures that all claim documentation is thoroughly reviewed and assessed for coverage ...

Unicon Pharma Inc.

Claims Analyst I

Parsippany, NJ · On-site

$50 - $70/hr

Medicaid Claim processing function; manipulation of large datasets, negotiation/conflict resolution. System Implementation and report writing. - Revitas/Flex Medicaid and advance Microsoft Excel ...

MUSC

Claims Processor II

Orangeburg, SC · On-site

$16.25 - $20.50/hr

Summary Under general supervision assures accurate and timely insurance claim processing to include resolving claim edits and paper claims for submittal. Resolves denied/unpaid insurance claims in a ...

Solis Health Plans

Claim Examiner I

Miami, FL · On-site

$19 - $23/hr

Evaluate and process claim disputes and reconsiderations , including those that result in overturn decisions requiring correction and re-adjudication. * Handle appeals-related claim adjustments ...

Solis Health Plans

Claim Examiner I

Miami, FL · On-site

$19 - $23/hr

Evaluate and process claim disputes and reconsiderations , including those that result in overturn decisions requiring correction and re-adjudication. * Handle appeals-related claim adjustments ...

Sourcedge Solutions

FACETS Claims Processor

Albany, NY · Remote

$17 - $21.25/hr

Must have 5+ years of relevant claim processing experience in healthcare industry (managed care or TPA Company) to support our clients * Possess high productivity and quality standards within a ...

CVS Health

Claim Benefit Specialist OPS

$17 - $28.46/hr

Position Summary Processing Medicare claims on the HRP-HealthEdge Platform The Claim Benefit Specialist position is a production-based role servicing Medicare Advantage beneficiaries. Additional ...

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Claim Processor information

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How much do claim processor jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for claim processor in the United States is $19.16, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $20.67 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.
More about Claim Processor jobs

What cities are hiring for Claim Processor jobs?

Cities with the most Claim Processor job openings:

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

The most popular types of Claim Processor jobs are:

Who are the top companies hiring for Claim Processor jobs?

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What states have the most Claim Processor jobs?

States with the most job openings for Claim Processor jobs include:

Claim Processor jobs near you
Infographic showing various Claim Processor job openings in the United States as of August 2026, with employment types broken down into 79% Full Time, 19% Part Time, and 2% Contract. Highlights an 81% Physical, 6% Hybrid, and 13% Remote job distribution, with an average salary of $39,863 per year, or $19.2 per hour.

Claim Specialist

Winston Staffing Services

Jericho, NY • On-site

$27 - $28/hr

Contractor

Posted 12 days ago

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Job description


The Claims Specialist is responsible for effectively managing and resolving complex medical claims disputes. This role requires a strong understanding of healthcare regulations, excellent communication and interpersonal skills, and the ability to work independently and collaboratively within a fast-paced environment.

Key Responsibilities

1. Claim Resolution

  • Adjudication: Independently and accurately adjudicate appeals and disputes for medical claims, ensuring compliance with all relevant regulations and contractual agreements.
  • Communication: Effectively communicate with healthcare providers, payers, and members regarding claim status and resolution.
  • Issue Prevention: Proactively identify and resolve potential claim issues to minimize denials and expedite claim payments.
  • Documentation: Maintain accurate and timely documentation of all claim activities within the Electronic Health Record (EHR) or other designated systems.

2. Process Improvement

  • Data Analysis: Analyze claim data to identify trends and areas for improvement in claim processing efficiency and accuracy.
  • Workflow Optimization: Develop and implement process improvements to streamline claim workflows and reduce turnaround times.
  • Cross-Functional Collaboration: Collaborate with cross-functional teams to identify and resolve systemic issues that impact claim processing.

3. Client Relations

  • Relationship Management: Build and maintain strong relationships with clients, providers, and payers through effective communication and exceptional customer service.
  • Issue Resolution: Proactively address client concerns and resolve issues in a timely and professional manner.

4. Teamwork & Collaboration

  • Team Contribution: Actively participate in team meetings and contribute to a positive and collaborative work environment.
  • Mentorship: Mentor and train new team members on claim processing procedures and best practices.
  • Knowledge Sharing: Share knowledge and expertise with colleagues to enhance team performance.

5. Compliance & Quality Assurance

  • Regulatory Compliance: Ensure compliance with all applicable laws, regulations, and accreditation standards.
  • Quality Standards: Maintain a high level of accuracy and quality in all claim processing activities.
  • Auditing: Participate in quality assurance reviews and audits.

Performance Standards


Claim Resolution Accuracy

Achieve and maintain a high level of accuracy in claim adjudication, measured by the percentage of claims resolved correctly on the first attempt.

Processing Timeliness

Meet established service level agreements (SLAs) for claim processing and resolution, measured by average turnaround time.

Client Satisfaction

Maintain high levels of client satisfaction measured by client feedback surveys and relevant metrics.

Productivity

Achieve and maintain high levels of productivity measured by the number of claims processed per unit of time.

Compliance

Maintain 100% adherence to all applicable laws, regulations, and accreditation standards.

Qualifications

  • Education: Bachelor's degree in Healthcare Administration, Business Administration, or a related field.
  • Experience: Minimum of 2 years of experience in medical claims processing or a related field.
  • Knowledge: Strong understanding of healthcare regulations and reimbursement methodologies.
  • Technical Skills: Proficiency in Microsoft Office Suite and other relevant software applications.
  • Soft Skills: Excellent written and verbal communication, interpersonal skills, and ability to work both independently and within a team.
  • Analytical Skills: Strong problem-solving, organizational, time management, and analytical skills with a high degree of attention to detail.


Required Qualifications

  1. Education:
    • Requirement: Bachelor's degree in Healthcare Administration, Business Administration, or a related field.
    • Verification: Degree verification from an accredited institution.
  3. Experience:
    • Requirement: Minimum of 2 years of experience in medical claims processing or a related field.
    • Verification: Resume/CV review, background check (employment history).
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About Winston Staffing

Sourced by ZipRecruiter

Winston Staffing, based in New York, NY, US is a renowned leader in the staffing and human resources industries, providing a diverse range of services such as temporary staffing, permanent placement, executive search, and consulting services. Founded in 1967, Winston has remained dedicated to matching the right talent with the right opportunities, thereby solidifying their reputation for excellence. The company operates according to a set of core values that emphasize integrity, professionalism, teamwork, and mutual respect. The mission of Winston Staffing is to deliver innovative staffing solutions and provide top-tier talent to help their clients succeed. Winston’s achievements are broad and varied, demonstrating expertise and proficiency in multiple industry sectors. They have built long-standing relationships with a multitude of firms, becoming an integral part of their clients' success.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

New York, NY, US

Year founded

1967

Social media

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