ZipRecruiter

Log In

1

Claims Operations Associate Jobs in Springfield, IL

Comcast

Xfinity Retail Service Associate

Springfield, IL · On-site

$17.05/hr

This role serves as a go-to technical and operational resource, helping to maintain a clean and ... Process returns or exchanges in compliance with company policies. * Assist with warranty claims and ...

next page

Showing results 1-20

All JobsClaims Operations Associate JobsClaims Operations Associate Jobs in Springfield, IL

Claims Operations Associate information

See Springfield, IL salary details

$13

$20

$30

How much do claims operations associate jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for claims operations associate in Springfield, IL is $20.80, according to ZipRecruiter salary data. Most workers in this role earn between $16.92 and $22.88 per hour, depending on experience, location, and employer.

What is a claims operations associate?

A Claims Operations Associate is a professional who supports the processing and administration of insurance claims. They handle tasks such as reviewing claim forms, verifying information, entering data into systems, and assisting claims adjusters or examiners with documentation and communications. Their role is crucial in ensuring that claims are processed efficiently, accurately, and in compliance with company policies and regulatory requirements. Claims Operations Associates may work for insurance companies, healthcare providers, or third-party administrators.

What skills and qualifications are needed to be a claims operations associate?

To thrive as a Claims Operations Associate, you need strong analytical abilities, attention to detail, and a solid understanding of insurance processes, often supported by a bachelor's degree or relevant experience. Familiarity with claims management systems, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent communication, organizational skills, and problem-solving abilities help you manage complex claims and collaborate effectively with internal and external stakeholders. These competencies ensure accurate, efficient claims processing and contribute to customer satisfaction and organizational compliance.

What challenges might a claims operations associate encounter in their daily work?

As a Claims Operations Associate, you may encounter challenges such as managing a high volume of claims while ensuring accuracy and compliance with regulations. Balancing timely processing with the need to investigate discrepancies or incomplete information can be demanding. Additionally, you'll often coordinate with adjusters, customers, and other departments, so strong communication and organizational skills are essential. Staying up to date with changing policies or industry standards can also be a key part of the role.

What is the difference between Claims Operations Associate vs Claims Analyst?

AspectClaims Operations AssociateClaims Analyst
CredentialsHigh school diploma or equivalent; some roles may require relevant certificationsHigh school diploma; some roles may prefer certifications like CPCU or similar
Work EnvironmentOffice setting, handling claims processing and customer interactionsOffice or remote, analyzing claims data and making decisions
Employer & IndustryInsurance companies, third-party administratorsInsurance firms, claims departments
Search & Comparison IntentUnderstanding entry-level claims roles and responsibilitiesAnalyzing claims data and decision-making processes

The Claims Operations Associate typically handles claims processing tasks, customer service, and administrative duties within an insurance setting. In contrast, a Claims Analyst focuses more on analyzing claims data, assessing risks, and making decisions based on policy details. Both roles require knowledge of insurance policies and claims procedures, but the Claims Analyst often involves more analytical skills and data interpretation.

How much do claims operations associates make in the US?

Claims operations associates in the US typically earn an average salary ranging from $40,000 to $60,000 per year, depending on experience, location, and company size. Entry-level roles may start lower, while experienced professionals or those with specialized skills can earn higher salaries. Benefits often include health insurance, paid time off, and opportunities for advancement.

Is claims processing a stressful job?

Claims processing as a Claims Operations Associate can be stressful due to the need for accuracy, attention to detail, and meeting deadlines. The role often involves handling complex cases and working under time pressure, which can contribute to job-related stress. However, workload and stress levels vary depending on the employer and individual workload management skills.

What are the most commonly searched types of Claims Operations jobs in Springfield, IL?

The most popular types of Claims Operations jobs in Springfield, IL are:

What cities near Springfield, IL are hiring for Claims Operations Associate jobs?

Cities near Springfield, IL with the most Claims Operations Associate job openings:

Claims Operations Associate jobs near you
Infographic showing various Claims Operations Associate job openings in Springfield, IL as of August 2026, with employment types broken down into 76% Full Time, 21% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $43,265 per year, or $20.8 per hour.

Medical Insurance Specialist (Extra Help/Temporary) (5572)

Springfield, IL • On-site

SIU Medicine
See more jobs at SIU Medicineexternal

$17.75 - $23.75/hr

Other

Posted 3 days ago

New

Job description

Description

To help manage epic transition- including tasks such as claim corrections, Medicaid DDE entries, TES edits, and appeals - additional support is necessary to maintain operational efficiency, meet performance standards, and reduce the risk of errors or backlogs.

*This position is ON SITE only*

Examples of Duties
  • Analyze patient accounts to ensure insurance billing is accurate and complete.
  • Enter and verify patient demographic and insurance data in the practice management system (PMS).
  • Collect and confirm patient insurance eligibility using online tools, payer websites, and direct communication with insurance companies, guarantors, or patients.
  • Assist with patient refunds and handle patient account credits in accordance with policy.
  • Review and process basic insurance denials, including pulling related medical records and performing manual charge entry as needed.
  • Review Explanation of Benefits (EOBs) for accuracy and follow up on denied claims.
  • Document actions taken in billing systems and update relevant modules accordingly.
  • Review medical records and assign appropriate diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS coding systems.
  • Ensure proper use and assignment of evaluation and management (E/M) modifiers and procedure-specific modifiers.
  • Respond to inquiries from Patient Business Services (PBS) regarding claim corrections, including coding, service dates, place of service, and provider information.
  • Draft and submit appeal letters to insurance payers for reconsideration of denied claims based on coding or documentation review.
  • Self-Pay Credits (Credit Balance ETM)
  • Self- pay credits go well, we could add insurance credits (Credit Balance ETM)
  • Scanning Paper Documents in the office
  • Correspondence denial posting
  • Work no-activity claims views
  • Work claims in Medicaid DDE (direct data entry) system
  • Work eligibility denial views
  • Eligibility ETM
  • Ins follow up ETM
  • Patient Correspondence
  • CLS accounts (Bad Debt)
  • Self-set up payment plans-needing set up in IDX
  • Assist with gathering medical records
  • Manually create visits for patients in order to post charges
  • Work TES edits
Qualifications
  1. Any one or combination totaling two (2) years (24 months), from the categories below:
    1. College coursework in a health-related field, business administration/management, human resource management, or closely related fields, as measured by the following conversion table or its proportional equivalent:
      • 30 semester hours equals one (1) year (12 months)
      • Associate's Degree (60 semester hours) equals eighteen months (18 months)
      • 90 semester hours equals two (2) years (24 months)
    2. Work experience in a healthcare environment working independently with medical claims, denials, rejections, referrals, and prior authorizations.
Supplemental Information

If you require assistance, please contact the Office of Human Resources at hrrecruitment@siumed.edu or call 217-545-0223 Monday through Friday, 8:00am-4:30pm.

The mission of Southern Illinois University School of Medicine is to optimize the health of the people of central and southern Illinois through education, patient care, research and service to the community.

The SIU School of Medicine Annual Security Report is available online at https://www.siumed.edu/police-security. This report contains policy statements and crime statistics for Southern Illinois University School of Medicine in Springfield, IL. This report is published in compliance with Federal Law titled the "Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act."

Southern Illinois University School of Medicine is an affirmative Action/Equal Opportunity employer who provides equal employment and educational opportunities for all qualified persons without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, protected veteran status or marital status in accordance with local, state and federal law.

Pre-employment background screenings required.

#J-18808-Ljbffr

Apply