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Claim Representative Jobs (NOW HIRING)

CCMSI

Claim Representative, Medical Only

Metairie, LA · On-site

$20.51/hr

Overview Claim Representative, Medical Only Location : Metairie, LA (Onsite) Schedule: Monday-Friday, 8:00 AM - 4:30 PM Salary Range: $40,000 annually ($20.51/hour) Build Your Career With Purpose at ...

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How much do claim representative jobs pay per hour?

As of Jun 15, 2026, the average hourly pay for claim representative in the United States is $24.12, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $27.40 per hour, depending on experience, location, and employer.

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

To thrive as a Claim Representative, you need a solid understanding of insurance policies, strong analytical abilities, and typically a bachelor's degree or relevant experience in insurance or finance. Familiarity with claims management software, CRM systems, and sometimes industry certifications like AIC (Associate in Claims) are common requirements. Excellent communication, negotiation, and customer service skills help you effectively resolve disputes and support clients during stressful situations. These skills are vital for ensuring accurate claim assessments, maintaining customer satisfaction, and upholding the company's reputation.

What is a claims representative?

A claims representative is a professional who investigates, evaluates, and processes insurance claims to determine coverage and settlement amounts. They review documentation, interview claimants, and use industry knowledge and tools to ensure accurate and fair claim resolution.

What are claim representatives?

Claim representatives, also known as claims adjusters or insurance claim specialists, are professionals who investigate insurance claims to determine the extent of an insurance company's liability. They review documentation, interview claimants and witnesses, inspect property damage or injuries, and negotiate settlements. Their role is to ensure that claims are handled efficiently, fairly, and in accordance with policy terms. Claim representatives play a crucial part in the insurance industry by helping resolve claims for policyholders and maintaining trust in the company.

What jobs pay 2000 a day?

Claim representatives typically do not earn $2,000 a day; their salaries are usually based on an annual or hourly rate. High-paying roles in the insurance or legal industries, such as senior claims managers or specialized adjusters, may reach that level with bonuses or commissions, but these are uncommon. Most jobs paying $2,000 daily are executive, consulting, or entrepreneurial roles requiring significant experience and responsibility.

What job makes $10,000 a month without a degree?

A Claim Representative typically does not earn $10,000 a month without specialized experience or certifications. High earnings in insurance-related roles may require advanced skills, industry knowledge, or management responsibilities, but such salaries are uncommon without a degree or extensive experience. Most high-paying jobs without a degree involve sales, entrepreneurship, or skilled trades, rather than claim handling roles.

What are the duties of a claims representative?

A claims representative investigates insurance claims by reviewing policies, collecting evidence, and assessing damages. They determine coverage eligibility, negotiate settlements, and ensure claims are processed accurately and efficiently, often using claims management software. Strong communication and analytical skills are essential for this role.

What is the difference between Claim Representative vs Claims Adjuster?

AspectClaim RepresentativeClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require insurance licensesHigh school diploma; insurance licenses often required
Work EnvironmentOffice settings, customer interactions, claims processingFieldwork and office work, investigating claims
Employer & Industry UsageInsurance companies, government agenciesInsurance companies, third-party administrators

Both Claim Representatives and Claims Adjusters work in the insurance industry, handling claims and assisting clients. Claim Representatives typically focus on customer service and initial claim processing, while Claims Adjusters investigate and evaluate claims, often in the field. Understanding these differences helps job seekers find roles aligned with their skills and credentials.

What are some common challenges a Claim Representative might face, and how can they be addressed?

Claim Representatives often encounter challenges such as managing a high volume of claims, handling complex or disputed cases, and maintaining clear communication with policyholders, service providers, and legal teams. Developing strong organizational skills and time management strategies can help prioritize tasks effectively. Additionally, staying up to date with industry regulations and company protocols, as well as building rapport with customers, can make navigating difficult situations more manageable and lead to better outcomes for all parties involved.
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Claim Representative jobs near you
Claim Representative, Medical Only

Claim Representative, Medical Only

CCMSI

Metairie, LA • On-site

$20.51/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 25 days ago

Job description

OverviewClaim Representative, Medical Only  Location: Metairie, LA (Onsite)Schedule: Monday-Friday, 8:00 AM - 4:30 PMSalary Range: $40,000 annually ($20.51/hour)Build Your Career With Purpose at CCMSIAt CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary 

The Medical Only Claim Representative is responsible for the handling of designated workers' compensation medical-only claims and providing support to claim staff across multiple accounts. This role manages a high-volume caseload of primarily low-complexity claims, including basic medical-only claims, subrogation opportunities, Second Injury Fund (SIF) considerations, and ongoing medical management on older claims.

This position serves as a foundational development role, offering training and growth into intermediate-level adjuster positions. The role requires strong organization, attention to detail, and the ability to communicate effectively with claimants, medical providers, and internal teams while delivering accurate, compliant, and timely claim outcomes.

ResponsibilitiesWhen we hire claim reps at CCMSI, we look for detail oriented professionals who understand that every task supports a real person's claim experience, value accuracy and responsiveness, and contribute to the team's success through organization, collaboration, and a strong commitment to service. Set up and manage medicalonly claim files in accordance with corporate claim standards and applicable laws  Establish reserves and provide reserve recommendations within authorized levels under direct supervision  Review and approve medical and miscellaneous invoices on designated claims; negotiate disputed bills or invoices under supervision  Request and monitor medical treatment in accordance with corporate claim handling standards  Summarize correspondence and medical records in claim system notes and file documentation appropriately  Close claim files when appropriate and retrieve closed files for refiling as requested  Provide ongoing support to claim staff on client service teams  Communicate with medical providers, injured workers, and internal partners; frequent phone work is required  Ensure compliance with corporate claim handling standards and special client handling instructions QualificationsRequired:   Active Louisiana Adjuster License or the ability to obtain within first 60 days of employment  Associate Degree or minimum of two (2) years of related business, insurance, or administrative experience Basic understanding of workers' compensation and willingness to develop technical claim knowledge Strong customer service skills with comfort handling phone-based communication Excellent organizational, time management, and prioritization skills Ability to manage a high-volume caseload with accuracy and efficiency Strong written and verbal communication skills Proficiency with Microsoft Office applications (Word, Excel, Outlook) Reliable, predictable attendance during assigned business hoursNice to Have:   Knowledge of medical terminology  Prior experience in claims, insurance, or medical administrative support  Experience supporting a single client or program environment  Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required.  Why You'll Love Working Here  4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year  Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance  Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)  Career growth: Internal training and advancement opportunities  Culture: A supportive, team-based work environment  How We Measure SuccessAt CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:   Quality claim handling - thorough investigations, strong documentation, well-supported decisions  Compliance & audit performance - adherence to jurisdictional and client standards  Timeliness & accuracy - purposeful file movement and dependable execution  Client partnership - proactive communication and strong follow-through  Professional judgment - owning outcomes and solving problems with integrity  Cultural alignment - believing every claim represents a real person and acting accordingly  This is where we shine, and we hire adjusters who want to shine with us.

 

Compensation & ComplianceThe posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.Our Core ValuesAt CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who:  
  • Lead with transparency We build trust by being open and listening intently in every interaction. 
  • Perform with integrity We choose the right path, even when it is hard. 
  • Chase excellence We set the bar high and measure our success. What gets measured gets done. 
  • Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. 
  • Win together Our greatest victories come when our clients succeed. 
We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.#CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #TPA #MedicalOnlyClaims #IND456 #MetairieJobs #NowHiring #LI-InOffice #MedicalOnlyClaims #ClaimsRepresentative #InsuranceCareersEmployment Type: OTHER

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