Ensure claims meet vendor requirements, gather supporting materials, and address disputes or ... here are representative of those that must be met to successfully perform the essential job ...
Ensure claims meet vendor requirements, gather supporting materials, and address disputes or ... here are representative of those that must be met to successfully perform the essential job ...
Claims Auditor
San Antonio, TX · On-site
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Claims Auditor
San Antonio, TX · On-site
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Claims Auditor
San Antonio, TX · On-site
$19.55 - $29.75/hr
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Claims Auditor
San Antonio, TX · On-site
$19.55 - $29.75/hr
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Claims Coordinator
Mason, OH · On-site
$22.55/hr
Accurately and efficiently process a variety of vision insurance claims and claim adjustments ... Client Representatives, and leadership. * Provide strong customer service and professional ...
Claims Coordinator
Mason, OH · On-site
$22.55/hr
Accurately and efficiently process a variety of vision insurance claims and claim adjustments ... Client Representatives, and leadership. * Provide strong customer service and professional ...
Claims Service Correspondent
Manhattan, NY · On-site
$55K - $64K/yr
... and Claims Processing unit. Scope of Role & Responsibilities * Act as a key liaison and service representatives for all written provider inquiries and problem resolution. * Respond to all claim ...
Claims Service Correspondent
Manhattan, NY · On-site
$55K - $64K/yr
... and Claims Processing unit. Scope of Role & Responsibilities * Act as a key liaison and service representatives for all written provider inquiries and problem resolution. * Respond to all claim ...
Claims Auditor
San Antonio, TX · On-site
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Claims Auditor
San Antonio, TX · On-site
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Medical Biller/Claims Processing
Phoenix, AZ · Remote
$23/hr
As a Patient Support Medical Billing Representative ,you'llbe part of a team that delivers ... Evaluate claims against program-specific business rules todetermineapproval or rejection.
Medical Biller/Claims Processing
Phoenix, AZ · Remote
$23/hr
As a Patient Support Medical Billing Representative ,you'llbe part of a team that delivers ... Evaluate claims against program-specific business rules todetermineapproval or rejection.
Claims Service Correspondent
Manhattan, NY · Hybrid
$55K - $64K/yr
... and Claims Processing unit. Scope of Role & Responsibilities * Act as a key liaison and service representatives for all written provider inquiries and problem resolution. * Respond to all claim ...
Claims Service Correspondent
Manhattan, NY · Hybrid
$55K - $64K/yr
... and Claims Processing unit. Scope of Role & Responsibilities * Act as a key liaison and service representatives for all written provider inquiries and problem resolution. * Respond to all claim ...
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Claims Auditor
San Antonio, TX · On-site
$19.55 - $29.75/hr
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Claims Auditor
San Antonio, TX · On-site
$19.55 - $29.75/hr
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Processor, Claims I
$17.50 - $22/hr
... processing requirements based on contracts, policies and procedures. Process product or system ... The requirements listed below are representative of the knowledge, skill, and/or ability required.
New
Processor, Claims I
$17.50 - $22/hr
... processing requirements based on contracts, policies and procedures. Process product or system ... The requirements listed below are representative of the knowledge, skill, and/or ability required.
New
Claims Auditor
San Antonio, TX · On-site
$19.55 - $29.75/hr
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Claims Auditor
San Antonio, TX · On-site
$19.55 - $29.75/hr
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Claims Auditor
San Antonio, TX · On-site
$19.55 - $29.75/hr
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Claims Auditor
San Antonio, TX · On-site
$19.55 - $29.75/hr
Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...
Claims Processing Lead - WTCHP TPA
WV · On-site +1
Coordinate with medical providers and federal program representatives to resolve billing disputes ... claims processing, with at least 2 years in a lead, supervisory, or senior auditing capacity.
Claims Processing Lead - WTCHP TPA
WV · On-site +1
Coordinate with medical providers and federal program representatives to resolve billing disputes ... claims processing, with at least 2 years in a lead, supervisory, or senior auditing capacity.
Participant Claims Liaison
Olean, NY · On-site
Processes medical claims received from Providers for payment. * Reviews and verifies medical ... The minimum qualifications listed are representative of the knowledge, skill and/or ability ...
Quick apply
Participant Claims Liaison
Olean, NY · On-site
Processes medical claims received from Providers for payment. * Reviews and verifies medical ... The minimum qualifications listed are representative of the knowledge, skill and/or ability ...
Job Title - Claims Resolution Representative Job Location - Remote Duration - 6 Months Contract to ... Ensure accuracy and consistency in claims processing. * Research and review submitted claims ...
Job Title - Claims Resolution Representative Job Location - Remote Duration - 6 Months Contract to ... Ensure accuracy and consistency in claims processing. * Research and review submitted claims ...
Participant Claims Liaison
Olean, NY · On-site
Processes medical claims received from Providers for payment. * Reviews and verifies medical ... The minimum qualifications listed are representative of the knowledge, skill and/or ability ...
Quick apply
Participant Claims Liaison
Olean, NY · On-site
Processes medical claims received from Providers for payment. * Reviews and verifies medical ... The minimum qualifications listed are representative of the knowledge, skill and/or ability ...
Medical Biller/Claims Processing
Atlanta, GA · Remote
$23/hr
As a Patient Support Medical Billing Representative ,you'llbe part of a team that delivers ... Evaluate claims against program-specific business rules todetermineapproval or rejection.
Medical Biller/Claims Processing
Atlanta, GA · Remote
$23/hr
As a Patient Support Medical Billing Representative ,you'llbe part of a team that delivers ... Evaluate claims against program-specific business rules todetermineapproval or rejection.
Medical Biller/Claims Processing
Houston, TX · Remote
$23/hr
As a Patient Support Medical Billing Representative ,you'llbe part of a team that delivers ... Evaluate claims against program-specific business rules todetermineapproval or rejection.
Medical Biller/Claims Processing
Houston, TX · Remote
$23/hr
As a Patient Support Medical Billing Representative ,you'llbe part of a team that delivers ... Evaluate claims against program-specific business rules todetermineapproval or rejection.
Claims Processing Representative information
See salary details
$11.54 - $14.31
4% of jobs
$14.31 - $17.09
14% of jobs
$18.17 is the 25th percentile. Wages below this are outliers.
$17.09 - $19.86
19% of jobs
The median wage is $21.67 / hr.
$19.86 - $22.64
21% of jobs
$22.64 - $25.42
14% of jobs
$26.53 is the 75th percentile. Wages above this are outliers.
$25.42 - $28.19
10% of jobs
$28.19 - $30.97
4% of jobs
$30.97 - $33.74
5% of jobs
$33.74 - $36.52
3% of jobs
$36.52 - $39.29
3% of jobs
$39.29 - $42.07
3% of jobs
$11
$24
$42
How much do claims processing representative jobs pay per hour?
As of Sep 10, 2026, the average hourly pay for claims processing 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 does a claims processing representative do?
A Claims Processing Representative is responsible for reviewing, processing, and resolving insurance claims submitted by policyholders or healthcare providers. They verify claim information, ensure all necessary documentation is included, and determine whether claims meet policy requirements. These professionals communicate with customers, providers, and other stakeholders to clarify details and resolve discrepancies. Their role is vital in ensuring that claims are handled accurately and efficiently, and that policyholders receive timely payments or explanations of benefits.
What skills and qualifications are needed to be a claims processing representative?
To thrive as a Claims Processing Representative, you need strong analytical abilities, attention to detail, and a solid understanding of insurance policies, typically supported by a high school diploma or equivalent. Familiarity with claims management software, data entry systems, and sometimes specific certifications like the Associate in Claims (AIC) are commonly required. Excellent communication, problem-solving, and organizational skills help representatives resolve issues efficiently and provide quality customer service. These competencies are crucial for accurately processing claims, minimizing errors, and ensuring timely payments to policyholders.
How does a claims processing representative collaborate with other departments?
Claims Processing Representatives frequently work alongside other teams such as underwriting, customer service, and medical review to ensure claims are processed accurately and efficiently. They may consult with underwriters to clarify policy details, coordinate with medical reviewers for documentation, and communicate with customer service to update clients on claim statuses. This collaborative environment helps resolve complex cases more quickly and ensures compliance with company policies and regulations. Strong communication skills and the ability to work cross-functionally are key to success in this role.
What is the difference between Claims Processing Representative vs Claims Adjuster?
| Aspect | Claims Processing Representative | Claims Adjuster |
|---|---|---|
| Required Credentials | High school diploma or equivalent; some roles may prefer insurance certifications | High school diploma; state licensing or certification often required |
| Work Environment | Office settings, customer service centers | Field work and office settings, inspecting claims |
| Industry Usage | Insurance companies, third-party administrators | Insurance companies, independent adjusters |
| Common Search/Comparison | Claims Processing Representative vs Claims Adjuster |
The main difference is that Claims Processing Representatives handle administrative tasks, review claims, and communicate with claimants, while Claims Adjusters investigate and evaluate claims, often inspecting damages or losses. Both roles are essential in the insurance industry but focus on different stages of the claims process.
What states have the most Claims Processing Representative jobs?
States with the most job openings for Claims Processing Representative jobs include:
What are popular job titles related to Claims Processing Representative jobs?
For Claims Processing Representative jobs, the most frequently searched job titles are:
Claims Processing Specialist Intern
Moraine, OH • On-site
Winsupply
Internship
Posted 8 days ago
Winsupply rating
6.7
Based on 91 frontline employees who took The Breakroom Quiz
Job description
Company Description
Winsupply is in the business of creating and enabling entrepreneurs to achieve their dreams through wholesale distribution. Winsupply is a group of over 680 locally-owned companies that operate across a variety of industries, including HVAC, Plumbing, Electrical and more. The purpose of the support services campus is to eliminate obstacles and provide support to help our entrepreneurs succeed. Support service employees assist entrepreneurs in achieving their dreams through finance, accounting, IT, and other back-office operations.
Job Description
Internship Summary
The Winsupply Internship Program offers students a unique opportunity to build valuable skills through immersive classroom learning, off-site training, and a collaborative capstone project. The program is structured to promote professional development by offering mentorship, meaningful networking opportunities, and hands-on experience in real-world projects. Participants will not only develop their careers but also make a significant impact within the Winsupply organization, contributing to innovative solutions and long-term success.
Position Summary
Winsupply Sourcing Services (WSS) manages 2 million square feet of warehouse space, providing inventory and vendor management for over 650 entrepreneurial wholesale businesses nationwide. This role supports WSS's operations by ensuring accurate inventory records, pricing, and timely vendor claims. With nearly 750,000 transactions annually, you'll collaborate with vendors and customers to drive efficiency and support small business success.
Key Responsibilities
Competencies for Success
Qualifications
Minimum Qualifications
Additional Information
Physical Demands
The physical demands here are representative of those that must be met to successfully perform the essential job functions with or without reasonable accommodations:
We are committed to inclusion, diversity, and equal employment opportunity, regardless of race, color, ancestry, religion, sex, gender, national origin, sexual orientation, age, citizenship, marital status, disability, veteran status, or any other factor protected by applicable federal, state, or local laws.
Winsupply is in the business of creating and enabling entrepreneurs to achieve their dreams through wholesale distribution. Winsupply is a group of over 680 locally-owned companies that operate across a variety of industries, including HVAC, Plumbing, Electrical and more. The purpose of the support services campus is to eliminate obstacles and provide support to help our entrepreneurs succeed. Support service employees assist entrepreneurs in achieving their dreams through finance, accounting, IT, and other back-office operations.
Job Description
Internship Summary
The Winsupply Internship Program offers students a unique opportunity to build valuable skills through immersive classroom learning, off-site training, and a collaborative capstone project. The program is structured to promote professional development by offering mentorship, meaningful networking opportunities, and hands-on experience in real-world projects. Participants will not only develop their careers but also make a significant impact within the Winsupply organization, contributing to innovative solutions and long-term success.
Position Summary
Winsupply Sourcing Services (WSS) manages 2 million square feet of warehouse space, providing inventory and vendor management for over 650 entrepreneurial wholesale businesses nationwide. This role supports WSS's operations by ensuring accurate inventory records, pricing, and timely vendor claims. With nearly 750,000 transactions annually, you'll collaborate with vendors and customers to drive efficiency and support small business success.
Key Responsibilities
- File and manage vendor claims for job quotes and special price allowances, ensuring accuracy and compliance.
- Maintain records of claim agreements, track open claims, and review related credits and charges.
- Ensure claims meet vendor requirements, gather supporting materials, and address disputes or inquiries.
- Develop expertise in WSS systems, maintain documentation, and identify process improvements.
Competencies for Success
- Communication Skills
- Proactiveness
- Adaptability
- Ability to work both independently and collaboratively
- Problem solving
- Networking skills
- Self-motivation
- Willingness to learn
- Critical thinking
- Integrity
Qualifications
Minimum Qualifications
- Currently enrolled in an accredited university or college, either at the undergraduate or master's level.
- One semester post-graduation
Additional Information
Physical Demands
The physical demands here are representative of those that must be met to successfully perform the essential job functions with or without reasonable accommodations:
- Sitting for extended periods of time.
- Dexterity of hands and fingers to operate a computer keyboard, mouse, and other computer components.
We are committed to inclusion, diversity, and equal employment opportunity, regardless of race, color, ancestry, religion, sex, gender, national origin, sexual orientation, age, citizenship, marital status, disability, veteran status, or any other factor protected by applicable federal, state, or local laws.
What Winsupply employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom