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Claim Specialist Jobs (NOW HIRING)

MEMIC

Claim Specialist I

Portland, ME · On-site

$60K - $70K/yr

Claim Specialist I This position is in-person to start then transitions to hybrid. *Prior claims handling experience required and one year of workers' compensation claim handling experience preferred*

MEMIC

Claim Specialist I

Portland, ME

$60K - $70K/yr

Claim Specialist I This position is in-person to start then transitions to hybrid. *Prior claims handling experience required and one year of workers' compensation claim handling experience preferred*

Winston Staffing Services

Be Seen First

Claim Specialist

Jericho, NY · On-site

$27 - $28/hr

The Claims Specialist is responsible for effectively managing and resolving complex medical claims ... Key Responsibilities 1. Claim Resolution * Adjudication: Independently and accurately adjudicate ...

MEMIC

Associate Claim Specialist

Portland, ME · Hybrid

$56K/yr

Associate Claim Specialist This position is in-office for the first six weeks then can transition to hybrid. Are you looking to build a career in insurance claims management? Join MEMIC as an ...

CCMSI

Workers' Compensation Claim Specialist

Concord, CA · On-site

$85K - $98K/yr

Overview Workers' Compensation Claim Specialist Location: Concord, CA (reporting remotely) Schedule: 8:00am-4:30pm Salary Range: $85,000 - $98,000 (depending on experience) Build Your Career With ...

MEMIC

Associate Claim Specialist

Portland, ME · On-site

$56K/yr

Associate Claim Specialist This position is in-office for the first six weeks then can transition to hybrid. Are you looking to build a career in insurance claims management? Join MEMIC as an ...

CCMSI

Workers' Compensation Claim Specialist

Concord, CA · On-site

$85K - $98K/yr

Workers' Compensation Claim Specialist Location: Concord, CA (reporting remotely) Schedule: 8:00am-4:30pm Salary Range: $85,000 - $98,000 (depending on experience) Build Your Career With Purpose at ...

FCCI Insurance Group

Claim Specialist

Birmingham, AL

$91K - $140K/yr

We are currently seeking an experienced commercial Claim Specialist to provide quality, cost efficient, and timely investigation of liability claims. Responsibilities include maintaining an inventory ...

Cesna Group

Claim Specialist

Englewood Cliffs, NJ · On-site

$50K - $100K/yr

Claim * Work Schedule: In-Office * Salary: Based on Experience * Review homeowners insurance claims to determine coverage eligibility based on policy * language, claim facts, and applicable laws ...

CCMSI

Multi-Line Claim Specialist

Chicago, IL

$80K - $90K/yr

Multi Line Claim Specialist Location: Hybrid- Reporting to Chicago, IL Region Chicago-area candidates preferred. This role may be performed remote in states where CCMSI is authorized to hire. Pay ...

CCMSI

Multi-Line Claim Specialist

Chicago, IL · On-site

$80K - $90K/yr

Multi Line Claim Specialist Location: Hybrid- Reporting to Chicago, IL Region Chicago-area candidates preferred. This role may be performed remote in states where CCMSI is authorized to hire. Pay ...

CCMSI

Multi-Line Claim Specialist

Chicago, IL · On-site

$80K - $90K/yr

Multi Line Claim Specialist Location: Hybrid- Reporting to Chicago, IL Region Chicago-area candidates preferred. This role may be performed remote in states where CCMSI is authorized to hire. Pay ...

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All JobsClaim Specialist Jobs

Claim Specialist information

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$12

$23

$43

How much do claim specialist jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for claim specialist in the United States is $23.50, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $25.72 per hour, depending on experience, location, and employer.

How much do claim specialists make in the US?

Claim specialists in the US typically earn an average annual salary of around $50,000 to $70,000, depending on experience, location, and employer. Salaries can vary based on certifications, such as the Certified Claims Professional (CCP), and the complexity of claims handled.

What is the difference between Claim Specialist vs Claims Adjuster?

AspectClaim SpecialistClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require insurance licensesHigh school diploma; state licensing often required
Work EnvironmentOffice settings, insurance companies, or claims centersFieldwork and office; inspecting damage and interviewing claimants
Employer & IndustryInsurance companies, third-party administratorsInsurance companies, public adjusting firms

Claim Specialists primarily handle customer inquiries, process claims, and verify documentation, often working in office settings. Claims Adjusters evaluate damages, inspect sites, and determine claim validity, often working in the field. Both roles require similar credentials and are integral to the insurance industry, but their daily tasks and work environments differ.

What are the key skills and qualifications needed to thrive as a claim specialist?

To thrive as a Claim Specialist, you need strong analytical abilities, attention to detail, and a solid understanding of insurance policies, often supported by a bachelor's degree or relevant experience. Familiarity with claims management software, industry-specific databases, and sometimes certifications like AIC (Associate in Claims) are typically required. Excellent communication, negotiation, and customer service skills help resolve disputes and ensure positive client interactions. These competencies are crucial for accurately processing claims, minimizing risk, and fostering trust between insurers and clients.

What does a claim specialist do?

A Claim Specialist is responsible for evaluating insurance claims submitted by policyholders to determine their validity and ensure accurate processing. They review documentation, investigate circumstances surrounding the claim, and communicate with clients, medical professionals, or other relevant parties. Claim Specialists also negotiate settlements, explain coverage details, and ensure compliance with company policies and legal regulations. Their role is crucial to maintaining fairness and efficiency in the insurance claims process.

What are some common challenges a claim specialist faces when handling complex claims?

Claim Specialists often encounter challenges such as investigating ambiguous or incomplete information, managing multiple claims simultaneously, and balancing the needs of the policyholder with company guidelines. They must also navigate sensitive conversations with clients who may be experiencing stress or loss, while ensuring all documentation complies with regulatory standards. Developing strong organizational, communication, and problem-solving skills can help overcome these challenges and contribute to successful claim resolutions.

What is the role of a claim specialist?

A claim specialist reviews and processes insurance claims to determine coverage and payout amounts. They investigate claim details, communicate with clients and providers, and ensure claims are handled accurately and efficiently, often using specialized software. Strong attention to detail and knowledge of insurance policies are essential for this role.
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What states have the most Claim Specialist jobs? States with the most job openings for Claim Specialist jobs include:
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Claim Specialist jobs near you
Infographic showing various Claim Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $48,885 per year, or $23.5 per hour.

Claim Specialist I

MEMIC

Portland, ME • On-site

$60K - $70K/yr

Full-time

Posted 17 days ago

Job description

About MEMIC
At MEMIC, our mission is to make workers' compensation insurance better-through compassionate service, trusted partnerships, and an unwavering focus on workplace safety. Our core values-Be Conscientious, Be an Expert, Be a Partner, Be Curious, and Be Transparent-drive everything we do. For over 30 years, we've been a leader in helping businesses protect their employees and reduce workplace injuries while delivering exceptional claims services.
Job Overview: Claim Specialist I
This position is in-person to start then transitions to hybrid.
*Prior claims handling experience required and one year of workers' compensation claim handling experience preferred*
Are you a natural investigator, problem solver, and relationship builder? Do you thrive in a fast-paced environment where every day presents a new challenge? If so, we invite you to join our team as a Claim Specialist I.In this role, you'll play a critical part in helping injured workers navigate the claims process while partnering with employers, agents, medical providers, and legal professionals to deliver fair, timely, and compassionate claim resolutions. You'll manage a diverse portfolio of workers' compensation claims, balancing analytical thinking, sound judgment, and exceptional customer service.
What You'll Do
As a Claim Specialist I, you will:
Investigate and Evaluate Workers' Compensation Claims
  • Gather facts, analyze coverage and compensability, determine liability, and assess claim exposure.
  • Conduct interviews and maintain communication with injured workers, employers, witnesses, attorneys, brokers, agents, and other stakeholders.

Manage Claims from Start to Finish
  • Administer timely and accurate indemnity and medical benefits.
  • Establish appropriate reserves and make informed settlement decisions within authority levels.
  • Negotiate claim resolutions and pursue cost-effective outcomes.

Partner with Legal and Medical Professionals
  • Collaborate with defense counsel on litigated claims.
  • Attend mediations, arbitrations, hearings, and settlement conferences when needed.
  • Implement managed care and rehabilitation strategies to support recovery and claim resolution.

Build Strong Relationships
  • Work directly with insureds and injured employees to provide guidance, education, and support.
  • Conduct on-site visits, presentations, and claim reviews to strengthen customer partnerships.

Maintain Excellence and Compliance
  • Ensure claim files meet quality standards, regulatory requirements, and company best practices.
  • Stay current on workers' compensation laws, regulations, and industry trends.
  • Utilize technology and claims systems to effectively manage workload and documentation.
What Makes You Successful
We're looking for professionals who bring:
  • Strong analytical, investigative, and problem-solving skills
  • Exceptional communication and negotiation abilities
  • Sound judgment and decision-making skills
  • The ability to manage multiple priorities in a deadline-driven environment
  • Strong customer service and relationship management skills
  • Attention to detail and commitment to quality file handling
  • A collaborative mindset and team-oriented approach
Knowledge & Experience
  • Prior claims handling experience required and one year of workers' compensation claim handling experience preferred
  • Computer skills, Word, Excel and Image Right preferred.
  • Must have valid driver's license.
  • Strong attention to detail and strong communication skills both verbal and written.
  • Adaptable/flexible and self-directed with the ability to manage time and other resources wisely.
  • Must have the ability to work effectively with other organizational team members.

MEMIC is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, ancestry, age, disability, genetics, gender identity, veteran's status, sexual orientation, or any other characteristic protected by law. MEMIC is an equal opportunity employer encouraging diversity in the workplace.
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Check out our benefit offerings here! Targeted salary range: $60,000 - $70,000/annually

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