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Claims Processing Jobs in Virginia (NOW HIRING)

InstantServe LLC

MMIS Systems Analyst

Richmond, VA · On-site

Virtual and In-Person We are seeking a highly skilled Systems Analyst with strong technical and analytical expertise in healthcare claims processing and comprehensive knowledge of data across all ...

Metis

Workers' Compensation Claims Associate

Roanoke, VA · On-site

$19.75 - $22.50/hr

Work closely with injured workers to guide them through the claims process. * Collect, review, and maintain proper documentation and records. Minimum Qualifications: * Bachelor's degree * Proficiency ...

1 point system

Manual Tester

Richmond, VA · On-site

We are seeking a highly skilled Systems Analyst with strong technical and analytical expertise in healthcare claims processing and comprehensive knowledge of data across all functional areas of the ...

ETS LLC

Software Engineer with Facets

Mclean, VA · On-site

Strong healthcare domain knowledge with deep understanding of ITS claims processing. Deep understanding of Facets integration components, data models, Membership/Claims architecture, and Facets FXI ...

Charter Global, Inc.

Facets Specialist

Reston, VA · On-site

$18.75 - $25/hr

The ideal candidates will have a strong background in healthcare payer systems, claims processing, benefits administration, and provider/member operations. Key Responsibilities For Project Manager ...

ALKEME Insurance

Claims Associate

Glen Allen, VA · On-site

$16.50 - $22.25/hr

Maintain a running diary and reference document summarizing all open claims. 3. Contribute to Process Improvement * Assist in structuring the Claims Division, including developing templates ...

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All JobsClaims Processing JobsClaims Processing Jobs in Virginia

Claims Processing information

See Virginia salary details

$11

$19

$26

How much do claims processing jobs pay per hour?

As of Jul 17, 2026, the average hourly pay for claims processing in Virginia is $19.00, according to ZipRecruiter salary data. Most workers in this role earn between $16.20 and $20.48 per hour, depending on experience, location, and employer.

What is the difference between Claims Processing vs Claims Adjuster?

AspectClaims ProcessingClaims Adjuster
CredentialsHigh school diploma or equivalent; certifications varyHigh school diploma; often state licensing or certifications
Work EnvironmentOffice-based, administrative settingFieldwork and office-based, investigative environment
Industry UsageInsurance companies, healthcare providersInsurance companies, claims departments
Job FocusReviewing and processing claims for paymentInvestigating claims, determining liability and settlement

Claims Processing involves reviewing and managing insurance claims to ensure proper payment, focusing on administrative tasks. Claims Adjusters investigate claims, assess damages, and determine liability. While both roles work within the insurance industry, Claims Processing is more administrative, whereas Claims Adjusters are investigative and evaluative.

What are some common challenges faced by professionals in claims processing, and how can they be managed effectively?

Professionals in claims processing often deal with high volumes of work, tight deadlines, and complex cases that require attention to detail. Managing these challenges involves staying organized, utilizing claims management software efficiently, and continuously updating knowledge of insurance policies and regulations. Effective communication with team members and other departments is also crucial to resolve discrepancies quickly and ensure accurate claim adjudication. Many organizations offer ongoing training and mentorship to help staff adapt to changes and improve efficiency.

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

To thrive as a Claims Processor, you need a solid understanding of insurance policies and claims procedures, typically supported by a high school diploma or equivalent and relevant on-the-job training. Familiarity with claims management software, data entry systems, and basic office applications is essential. Strong attention to detail, analytical thinking, and effective communication skills help you resolve claims accurately and efficiently. These skills ensure the timely and proper handling of claims, enhancing customer satisfaction and minimizing errors or fraudulent activity.

What is claims processing?

Claims processing is the procedure by which insurance companies or organizations review and manage claims submitted by policyholders or clients. This involves verifying the details of the claim, ensuring all necessary documentation is provided, assessing the validity of the claim, and determining the appropriate payout or resolution. Claims processors play a crucial role in ensuring claims are handled efficiently, accurately, and in compliance with company policies and regulations.
What are the most commonly searched types of Claims Processing jobs in Virginia? The most popular types of Claims Processing jobs in Virginia are:
What cities in Virginia are hiring for Claims Processing jobs? Cities in Virginia with the most Claims Processing job openings:
Claims Processing jobs near you
Infographic showing various Claims Processing job openings in Virginia as of July 2026, with employment types broken down into 100% Full Time. Highlights an 83% In-person, and 17% Remote job distribution, with an average salary of $39,522 per year, or $19 per hour.
MMIS Systems Analyst

MMIS Systems Analyst

InstantServe LLC

Richmond, VA • On-site

Full-time

Re-posted 14 days ago

Job description

Title: MMIS Systems Analyst
Location: Richmond, VA 23219-(Hybrid)
Interview: Virtual and In-Person
We are seeking a highly skilled Systems Analyst with strong technical and analytical expertise in healthcare claims processing and comprehensive knowledge of data across all functional areas of the Medicaid Management Information System (MMIS) or similar large-scale claims processing systems.
Key Responsibilities
Required Skills and Experience
Proven Agile Testing experience, with the ability to plan and execute functional, integration, and regression testing within iterative sprint cycles.
Data Analysis: Strong experience in data conversion, mapping rules, validation, ETL design, and programming logic.
*HIGHLY DESIRED: Mgr will give preference to people who have worked on MMIS or for Conduent (Company) in the past. Healthcare Claims Expertise: In depth knowledge of MMIS or similar large scale claims processing systems.
Technical Skills
Proficiency in Teradata, including query development.
Experience with Mainframe and DB2 testing preferred.
Test Management Tools: Extensive experience with Azure DevOps or similar platforms for planning, tracking, and executing test activities.
Defect Management: Strong experience leading UAT and defect triage across multiple systems/vendors.
Problem Solving: Strong debugging ability and experience acting as a liaison between developers and business users.
Excellent organizational and communication skills, with the ability to meet deadlines professionally and with strong customer focus.
Skill
Required / Desired
Amount
of Experience
Exp with Large-Scale Claims Processing Software (MMIS or similar): Mgr will give preference to people who have worked on MMIS or Conduent in past
Highly desired
5
8 Years
Experience in Data Analysis (large datasets, trend identification)
Required
10
15 +Years
Knowledge of Programming Logic
Required
10
15+Years
Experience in Data Conversion, Mapping Rules, and Validation
Required
10
15+Years
Experience in ETL Design and Data Transformation
Required
10
15+Years
Experience with Evaluating and Presenting Conversion Results
Required
10
15+Years
Experience with Teradata Queries and SQL
Required
10
15+Years
Ability to Document Data Conversion Rules and Validation Results
Required
10
12+Years
Experience in Data Quality Assurance and Reconciliation
Required
10
15+Years
Experience in Collaborating with ETL Developers and Business Teams
Required
10
15+Years
Experience with Azure DevOps or Similar Test Management Tools
Required
5
12+Years
Excellent organizational and communication skills; ability to meet deadlines with professionalism and customer focus.
Required
10
15+Years
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About InstantServe

Sourced by ZipRecruiter

InstantServe provides a one-stop solution to all Healthcare, IT/Non-IT Staffing needs. Established in 2016, InstantServe is a strong workforce of over 100+ go-getters with a demonstrated background in IT/Non-IT service. We are a nationally certified SBE from the Department of Administration (State of PA). As a proud Minority Woman Owned Small Business Enterprise (M/WBE), InstantServe boasts of a strong team of professionals who have extensive experience catering to several Federal, Public, Commercial, and Healthcare Clients which includes 26 States and 46 government agencies. InstantServe is a client-centric organization that offers cost-effective and reliable solutions. Client satisfaction is sacrosanct! Our team strives to provide the best staffing and IT solutions to take your business to the next level.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Wayne, PA, US

Year founded

2016

Social media

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