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Claims Assistant Jobs in Bothell, WA (NOW HIRING)

Puget Sound Energy

Claims Adjuster

Bellevue, WA

$72K - $103K/yr

The Claims department contributes to PSE's success by providing prompt and thorough investigation of reported incidents involving damages to third parties. Our team provides a valuable service to PSE.

Puget Sound Energy

Claims Adjuster

Bremerton, WA

$72K - $103K/yr

The Claims department contributes to PSE's success by providing prompt and thorough investigation of reported incidents involving damages to third parties. Our team provides a valuable service to PSE.

Uw

Claims and Litigation Manager

Seattle, WA · On-site

$153K/yr

The Claims and Litigation Manageraccomplisheshis/her mission by regularly sharing ... Assistant Attorneys General, University schools, colleges and divisions, and consulting ...

Physicians Insurance

Claims Service Associate

Seattle, WA · On-site +1

$70K - $105K/yr

We help them overcome obstacles with a team providing underwriting, risk-management, claims, and stop-loss expertise-backed by strong financials and all supported by exceptional, personalized service.

Progressive

Claims Adjuster Senior - Injury

Everett, WA · Hybrid

$36 - $47/hr

As a senior claims specialist on our team, you'll play a critical role in our ability to successfully and efficiently resolve injury claims. Investigating complex and high-risk claims - which may be ...

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How much do claims assistant jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for claims assistant in Bothell, WA is $23.53, according to ZipRecruiter salary data. Most workers in this role earn between $20.14 and $25.53 per hour, depending on experience, location, and employer.

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

To thrive as a Claims Assistant, you need strong organizational skills, attention to detail, and a basic understanding of insurance processes, often supported by a high school diploma or equivalent. Familiarity with claims management software, data entry systems, and office productivity tools like Microsoft Office is important. Excellent communication, customer service, and problem-solving skills help you interact effectively with clients and team members. These abilities ensure efficient claims processing, accurate documentation, and a positive customer experience.

What are the duties of a claims assistant?

A claims assistant works under the supervision of more senior claims examiners to ensure a claims adjuster and the claimants have followed the proper guidelines for filing claims. You also help adjusters deal with complex cases such as after a natural disaster hits and there are a significant number of claims coming in. As an assistant, you perform a number of administrative and clerical tasks which free examiners up to do other work. These duties include data entry, checking payment paperwork, confirming a claimant’s wage statement, and drafting report and billing paperwork.

What is the difference between Claims Assistant vs Claims Processor?

AspectClaims AssistantClaims Processor
Required CredentialsHigh school diploma or equivalent; some roles may prefer certifications in insurance or customer serviceHigh school diploma; certifications in insurance claims processing are a plus
Work EnvironmentOffice setting, interacting with clients and insurance agentsOffice or remote, focusing on reviewing and processing claims
Employer & Industry UsageInsurance companies, third-party administrators, and brokersInsurance companies, claims departments, and third-party administrators
Common Search & Comparison IntentUnderstanding entry-level claims roles and responsibilitiesClarifying the specific duties and qualifications of claims processing roles

Claims Assistants typically handle customer inquiries, gather documentation, and support claims processing, while Claims Processors focus on reviewing, evaluating, and approving claims. Both roles often require similar credentials and work in insurance settings, but their responsibilities differ in scope and focus.

How does a claims assistant typically interact with other departments during the claims process?

As a Claims Assistant, you will regularly collaborate with various teams such as adjusters, underwriters, and customer service representatives to ensure that claims are processed accurately and efficiently. Your role often involves gathering necessary documentation, clarifying claim details, and updating records, which requires clear communication and attention to detail. Effective teamwork and the ability to coordinate with different departments are essential, as you may need to follow up on missing information or escalate complex cases to senior staff. This collaborative environment helps ensure that claimants receive timely resolutions and supports the overall workflow of the claims department.

What is the role of a claims assistant?

A claims assistant supports insurance claims processing by reviewing claim forms, gathering necessary documentation, and communicating with clients and adjusters. They often use claims management software and need strong organizational and communication skills to ensure accurate and efficient handling of claims. The role may require familiarity with insurance policies and attention to detail.
More about Claims Assistant jobs
What are the most commonly searched types of Claims jobs in Bothell, WA? The most popular types of Claims jobs in Bothell, WA are:
What job categories do people searching Claims Assistant jobs in Bothell, WA look for? The top searched job categories for Claims Assistant jobs in Bothell, WA are:
What cities near Bothell, WA are hiring for Claims Assistant jobs? Cities near Bothell, WA with the most Claims Assistant job openings:
Claims Assistant jobs near you
Infographic showing various Claims Assistant job openings in Bothell, WA as of August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 24% Part Time, 1% Temporary, and 2% Contract. Highlights an 98% Physical, 1% Hybrid, and 1% Remote job distribution, with an average salary of $48,945 per year, or $23.5 per hour.

Amwins A&H- Claims Manager, Stop Loss

Amwins

Seattle, WA • On-site

Full-time

Re-posted 9 hours ago

Amwins rating

7.8

Company rating: 7.8 out of 10

Based on 38 frontline employees who took The Breakroom Quiz

189th of 304 rated insurance

Job description

Manager, Stop Loss Claims
(Remote)
Amwins Accident & Health Underwriters, formerly known as Beacon Risk Strategies, is conducting a search looking for an experienced Manager, Stop loss Claims.
Amwins Accident & Health (Amwins A&H) has primary locations in Seattle, WA and Atlanta, GA, and is a managing underwriter for several key carrier partners. We provide a unique approach to even the most challenging risk. Expertise includes Medical Stop Loss, Hospital Indemnity Plans, and other niche A&H products.
As a specialty underwriter, distributor, and program manager, Amwins A&H focuses on medical stop-loss and other accident and health products. Brokers, TPAs and reinsurers rely on the higher standard set by Amwins A&H in everything we do - from our thoughtful approach to underwriting to our tenacious focus on delivering superior cost containment, claims administration and customer service. Our employees pride themselves on prompt, personalized service and our customers have direct access to the claims and underwriting teams. Please visit www.amwins.com/opco/amwins-accident-health-underwriters
Amwins A&H is an Amwins Group Inc. company (www.amwins.com). Amwins is the largest wholesale brokerage and group insurance administrator in the US; we are privately held with annual placed premiums over $45b, over 165+ locations around the world, 60 operating companies and employs over 8.1k people.
Amwins has expertise across a diversified mix of property, casualty, and group benefits products, and offers value-added services to support some of these products, including product development, underwriting, premium and claims administration and actuarial services.
Position Overview
The Manager, Stop Loss Claims, will play a critical role in supporting the A&H claims organization by performing claims adjudication functions, managing complex, high-dollar and high-ambiguity stop loss claims, employing cost containment solutions, serving as a senior escalation point, and applying expert judgment to drive consistent, high-quality outcomes.
This role will be responsible for some personal claims production including, but not limited to, high dollar and complex stop loss claim reimbursement requests and will assist with overall claims department operations. It is designed to complement current claims leadership by adding depth of expertise, decision-making capacity, and mentorship through influence and credibility.
The successful candidate will bring deep stop loss claims experience, strong financial and contractual acumen, and the ability to operate effectively in gray areas where precedent, documentation, and interpretation require seasoned judgment.
Responsibilities
Stop Loss Claims Oversight
  • Serve as a senior escalation point for complex, high-dollar, or high-risk stop loss claims.
  • Review and evaluate claims requiring eligibility or medical necessity review, advanced contractual interpretation, medical judgment, or financial analysis.
  • Apply expert judgment to claim decisions that materially impact financial outcomes.
  • Identify trends, risks, and opportunities related to claim determinations and outcomes.
  • Support loss mitigation and cost containment through industry knowledge and expertise.
  • Participate in daily claim processing, escalated claim reviews and decision making.
  • Perform monthly and year-end aggregate claim reporting audits and review prior to referral to senior management.
  • Partner with internal teams to ensure consistent application of stop loss provisions and claims philosophy.

Collaboration & Influence
  • Work closely with existing management, claims leadership, underwriting, and operations teams.
  • Provide insight and recommendations on claims-related matters that influence pricing, program structure, and risk assessment.
  • Function as a trusted internal resource for complex claims discussions and decision-making.
  • Assist underwriting department in setting reserves for ongoing claimants.

Mentorship & Knowledge Sharing
  • Mentor and coach claims professionals through guidance, case review, and knowledge sharing.
  • Contribute to the development of training content or informal learning sessions as appropriate.
  • Elevate claims capability across the organization by sharing best practices and technical expertise.

Vendor & Partner Interaction
  • Engage with TPAs, carriers, and external partners on complex claims matters as needed.
  • Help manage, interpret and escalate reporting from TPA partners as needed.
  • Support alignment between internal claims philosophy and external partner execution.
  • Stay abreast of industry changes as related to emerging medical and pharmacy trends as well as cost containment solutions.

Qualifications
  • Bachelor's degree or equivalent experience required.
  • 10+ years of hands-on medical stop loss claims experience, including responsibility for complex, high-dollar, and high-ambiguity claims and understanding of self-funded claim funding processes.
  • Expert level understanding of physician and hospital billing practices, medical terminology, case management and utilization review reporting and industry claim processing best practices.
  • Demonstrated expertise interpreting stop loss contracts, plan documents, and policy language, including exclusions, limitations, aggregating specifics, lasers, and reimbursement thresholds.
  • Strong understanding of medical claims adjudication, including eligibility, coordination of benefits, medical necessity considerations, and primary drivers of large claims.
  • Proven ability to apply sound, defensible judgment in non-standard claims scenarios where documentation is incomplete, facts are disputed, or precedent is unclear.
  • Experience evaluating the financial impact of claims decisions, balancing contractual compliance, reimbursement outcomes, and long-term program integrity.
  • History of working with multiple TPA claim administrators and demonstrated ability to understand different claim reporting templates and to identify gaps in reports across partners.
  • Track record of serving as an escalation resource for complex claims issues, providing clear, well-reasoned recommendations to internal stakeholders.
  • Ability to collaborate effectively across functional departments including claims, underwriting, finance, legal, and operations without formal authority.
  • Experience mentoring or guiding other claims professionals through case review, technical coaching, or knowledge sharing.
  • Strong written and verbal communication skills, with the ability to clearly explain complex claims determinations to varied audiences.
  • Experience with Connexure, ESL Office software.

Core Competencies
  • Stop Loss Claims Judgment
    Applies consistent, defensible judgment in complex and high dollar stop loss claims through accurate interpretation of contract language, plan provisions, and medical documentation.
  • Technical Contract InterpretationDemonstrates deep expertise in stop loss contracts and plan documents, including exclusions, limitations, aggregating specifics, lasers, and reimbursement thresholds.
  • Financial Impact Evaluation
    Assesses the financial implications of claims decisions, balancing contractual compliance, reimbursement outcomes, and long-term program integrity.
  • Escalation & Decision Ownership
    Serves as a senior escalation point for ambiguous or disputed claims, providing clear recommendations and owning decisions through resolution.
  • Comfort with AmbiguityOperates effectively in non-standard claims scenarios where facts, documentation, or precedent are incomplete or conflicting.
  • Influence Through Expertise
    Elevates claims quality and consistency through technical credibility, mentorship, and collaboration rather than positional authority.

Pursuant to Washington regulation, the compensation range for this position is as stated and includes eligibility for performance-based bonuses.
Washington Pay Range
$140,000-$155,000 USD

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