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Claims Processor Associate Jobs in Pennsylvania (NOW HIRING)

Great American Insurance Group

$18.50 - $25.50/hr

Position Overview The Claims Operations Associate I is an entry-level support role responsible for ... Process and support routine claim-related transactions in accordance with established procedures.

Great American Insurance Group

$20 - $27/hr

Position Overview The Claims Operations Associate II provides operational and administrative ... Verify coverage, process claim-related transactions, and support payment and financial processing ...

Great American Insurance Group

$20 - $27/hr

Position Overview The Claims Operations Associate II provides operational and administrative ... Verify coverage, process claim-related transactions, and support payment and financial processing ...

Great American Insurance Group

$20 - $27/hr

Position Overview The Claims Operations Associate II provides operational and administrative ... Verify coverage, process claim-related transactions, and support payment and financial processing ...

Chubb

ESIS Claims Associate

Philadelphia, PA · On-site

$18 - $24.25/hr

Job Title Claims Associate Are you ready to make a meaningful impact in the world of workers ... Maintain control of the claims resolution process to minimize current exposure and future risks.

Munich Re

Claims Operations Associate

Philadelphia, PA · On-site

$18 - $24.25/hr

The Claim Operations Associate is a vital part of the MRSNA Claims team. The Associate helps to ... Request, process and import third-party data submissions while identifying any issues ...

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Claims Processor Associate information

What does a claims processor associate do?

A Claims Processor Associate is responsible for reviewing, processing, and verifying insurance claims to ensure they are accurate and comply with policy guidelines. They investigate claim details, communicate with policyholders or medical providers for additional information, and enter claim data into company systems. Their role is crucial in ensuring timely and accurate payments or denials, helping both insurance companies and clients. Attention to detail, strong organizational skills, and excellent communication abilities are important for success in this position.

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

To thrive as a Claims Processor Associate, you need strong attention to detail, analytical skills, and a high school diploma or equivalent, with some employers preferring experience in insurance or healthcare. Familiarity with claims management software, data entry systems, and basic office applications is typically required. Excellent organizational skills, clear communication, and the ability to work efficiently under deadlines are essential soft skills for this role. These abilities ensure accurate claims processing, minimize errors, and support timely service for clients and providers.

What are some common challenges faced by claims processor associates, and how can they be effectively managed?

Claims Processor Associates often encounter challenges such as handling a high volume of claims, navigating complex policy details, and meeting strict deadlines. Successfully managing these challenges requires strong organizational skills, attention to detail, and the ability to prioritize tasks effectively. Collaborating closely with team members and regularly communicating with supervisors can also help resolve discrepancies and ensure accuracy. Most organizations provide training and support to help associates stay updated on procedures and regulatory requirements, fostering a supportive work environment.

Is claims processing a stressful job?

Claims processing can be a stressful job due to tight deadlines, high volume of claims, and the need for accuracy. It often requires attention to detail, strong organizational skills, and the ability to handle complex or difficult cases. However, workload and stress levels vary depending on the employer and work environment.

What are the most commonly searched types of Claims Processor jobs in Pennsylvania?

The most popular types of Claims Processor jobs in Pennsylvania are:

What are popular job titles related to Claims Processor Associate jobs in Pennsylvania?

For Claims Processor Associate jobs in Pennsylvania, the most frequently searched job titles are:

What job categories do people searching Claims Processor Associate jobs in Pennsylvania look for?

The top searched job categories for Claims Processor Associate jobs in Pennsylvania are:

What cities in Pennsylvania are hiring for Claims Processor Associate jobs?

Cities in Pennsylvania with the most Claims Processor Associate job openings:

Claims Processor Associate jobs near you
Infographic showing various Claims Processor Associate job openings in Pennsylvania as of August 2026, with employment types broken down into 1% As Needed, 66% Full Time, 30% Part Time, 1% Temporary, 1% Contract, and 1% Nights. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution.

Claims Repricer

Philadelphia, PA • On-site

Independence Blue Cross
Insurance Services • 1 - 5K employees

8.8

Company rating: 8.8 out of 10

Based on 26 frontline employees who took The Breakroom Quiz

55th of 311 rated insurance

Good employer

Recommended by parents

Respectful managers

Learn more about Independence Blue Crossexternal

Full-time

Re-posted 15 days ago

Job description

Position Summary
The Claims Repricer is responsible for the accurate review, adjustment, and application of pricing methodologies to medical claims. This role ensures claims are priced in accordance with provider contracts, fee schedules, and benefit structures. The position plays a critical role in maintaining pricing integrity, minimizing rework, and supporting operational efficiency in a high-volume claims environment.
Key Responsibilities
  • Review and reprice medical claims to ensure accurate application of provider contracts, fee schedules, and reimbursement methodologies
  • Analyze pricing discrepancies and perform adjustments to align with contractual and system guidelines
  • Research complex claims scenarios, including escalations from Provider Services and Claims Processing
  • Partner with Configuration, Network Management, and Claims teams to resolve pricing issues and system defects
  • Validate contract terms and ensure proper interpretation within claims adjudication systems
  • Maintain productivity, quality, and turnaround time standards in a high-volume environment
  • Document findings and maintain audit-ready records of adjustments and issue resolution
  • Identify pricing trends, root causes, and recommend process improvements to reduce errors and rework

Required Qualifications
  • High school diploma or equivalent required; Associate's or Bachelor's degree preferred
  • 2-4 years of experience in healthcare claims processing, pricing, or repricing
  • Strong knowledge of claims adjudication and reimbursement methodologies (e.g., fee schedules, contract pricing)
  • Experience interpreting provider contracts and pricing logic preferred
  • Strong analytical and problem-solving skills with attention to detail
  • Ability to manage fluctuating workloads and prioritize effectively
  • Proficiency in Microsoft Office (Excel, Word) and claims systems

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

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