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Claims Processor Jobs in Scranton, PA (NOW HIRING)

Travelers

Associate Claim Rep, Auto Blend

Kingston, PA · On-site

$45K - $74K/yr

... claim processes, systems, and procedures, including virtual, classroom, and on-the-job training ... Assess claims for potential fraud. * Establish appropriate claim reserves, determine the claim ...

Erie Insurance

Property Adjuster I

Wilkes Barre, PA · Remote

$56K - $90K/yr

Also responsible for servicing assigned territory and may handle litigated claims. * This is a ... Optimizes Work Processes (IC) * Job-Specific Knowledge * Instills Trust * Ensures Accountability

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All JobsClaims Processor JobsClaims Processor Jobs in Scranton, PA

Claims Processor information

See Scranton, PA salary details

$11

$18

$26

How much do claims processor jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for claims processor in Scranton, PA is $18.97, 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 a claims processor?

A claims processor reviews insurance claims. Their responsibilities include verifying insurance policy coverage and making sure client information is accurate. After they determine there is a covered loss, a processor documents the information and makes sure all the required paperwork is complete. Other duties include modifying new or existing policies.

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

Claims Processors often encounter challenges such as managing high volumes of claims, handling complex or incomplete documentation, and meeting strict accuracy and timeliness standards. To navigate these, strong organizational skills, effective communication with colleagues and claimants, and attention to detail are crucial. Utilizing workflow management tools and maintaining open channels with supervisors and other departments can help address issues quickly and ensure claims are processed efficiently. Regular training and staying updated on policy changes also support success in this role.

Is claims processing a stressful job?

Claims processing is often considered a routine administrative role that involves reviewing and verifying insurance claims. While it can involve tight deadlines and attention to detail, the level of stress varies depending on workload, workplace environment, and individual coping skills.

What is the difference between Claims Processor vs Claims Examiner?

AspectClaims ProcessorClaims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require certificationHigh school diploma; certification often preferred
Work EnvironmentOffice setting, processing claims efficientlyOffice setting, reviewing and approving claims
Employer & Industry UsageInsurance companies, healthcare providersInsurance companies, government agencies
Common Search & ComparisonClaims Processor vs Claims Examiner

Claims Processors primarily handle the data entry and initial processing of insurance claims, focusing on accuracy and efficiency. Claims Examiners review claims for validity, compliance, and coverage before approval. While both roles work within the insurance industry and require similar credentials, Claims Examiners typically perform more detailed reviews and decision-making tasks. Understanding these differences helps job seekers identify the right role based on their skills and career goals.

What are the key skills and qualifications needed to thrive as a claims processor?

To thrive as a Claims Processor, you need strong analytical abilities, attention to detail, and knowledge of insurance policies, typically supported by a high school diploma or associate degree. Familiarity with claims management software, data entry systems, and sometimes industry certifications like AIC (Associate in Claims) is valuable. Excellent organization, communication, and customer service skills help you efficiently resolve claims and interact with clients. These competencies ensure accuracy, minimize errors, and maintain trust in the claims process.

Do you need a degree to be a claims processor?

A claims processor typically does not need a college degree, but employers often prefer candidates with a high school diploma or equivalent. Relevant skills include attention to detail, communication, and familiarity with claims processing software, and some positions may offer on-the-job training or certification programs.

What does a claims processor do?

A Claims Processor is responsible for reviewing, evaluating, and processing insurance claims submitted by policyholders. They verify the accuracy of the information provided, ensure all required documentation is present, and determine if the claim meets the policy's terms and conditions. Claims Processors work with both customers and insurance adjusters to resolve any discrepancies and help facilitate timely payments. Their role is essential in ensuring that claims are handled efficiently and fairly.
More about Claims Processor jobs
What are the most commonly searched types of Claims Processor jobs in Scranton, PA? The most popular types of Claims Processor jobs in Scranton, PA are:
What are popular job titles related to Claims Processor jobs in Scranton, PA? For Claims Processor jobs in Scranton, PA, the most frequently searched job titles are:
What job categories do people searching Claims Processor jobs in Scranton, PA look for? The top searched job categories for Claims Processor jobs in Scranton, PA are:
What cities near Scranton, PA are hiring for Claims Processor jobs? Cities near Scranton, PA with the most Claims Processor job openings:
Claims Processor jobs near you
Infographic showing various Claims Processor job openings in Scranton, PA as of August 2026, with employment types broken down into 1% Internship, 86% Full Time, 10% Part Time, 2% Contract, and 1% Nights. Highlights an 83% Physical, 5% Hybrid, and 12% Remote job distribution, with an average salary of $39,460 per year, or $19 per hour.

Manager, Revenue Cycle & Coding Compliance

The Wright Center Medical Group

Scranton, PA • On-site

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Job Type
Full-time
Description
POSITION SUMMARY
The Manager, Revenue Cycle and Coding Compliance is responsible for all aspects of the coding and billing of all inpatient and outpatient claims, as well as all aspects of the CCM billing. The Manager, Revenue Cycle and Coding Compliance, a key position in the Revenue Cycle, facilitates the coding as well as manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries and patients related to coding/billing issues. The incumbent will assist in the clarification and development of process improvements and inquiries in order to maximize revenues and will oversee the certified coding and billing / coding training & education teams.
REPORTING RELATIONSHIPS
The position reports to the Vice President, Controller Revenue Cycle. The position manages the coding & training team which includes: Compliance Coder & Trainer, Billing & Coding Educational Liaison, Coding team member(s), and the Billing Specialist.
ESSENTIAL JOB DUTIES and FUNCTIONS
While living and demonstrating our Core Values, the Manager Revenue cycle/Coding, Compliance & Education will:

  • Perform accurate and timely multi-specialty coding for daily claims submission.
  • Prepare and submit clean claims to third-party payers working closely with clinical team members regarding claims appeal, denial, and resolution.
  • Develop and maintain the ongoing audit process of the daily billing summary reviewing the quality of the clinical documentation and coded data to validate that the documentation supports services rendered while ensuring the integrity of the coding.
  • Respond timely (either orally or written) to account inquiries from patients, third-party payers, clinical providers, and/or other staff on claims submission.
  • Manage the daily workload of the billing specialist
  • Monitor AR over 120 Days
  • Perform ongoing trend analysis to ensure compliant contractual third-party payer reimbursement and work with appropriate individuals to resolve discrepancies
  • Prepare/review monthly aging reports
  • Establish and monitor best practice and standards to control the integrity and quality of data throughout the revenue cycle.
  • Actively participate in staff development, training and assessments to support industry best practice.
  • Ensure compliance with federal/state laws and regulations and billing and collection policies in order to facilitate attainment of account receivable targets
  • Interact with physicians, learners and other patient care providers on daily basis regarding billing and documentation policies, procedures, and regulations to ensure receipt and analysis of all charges; obtains clarification of conflicting, ambiguous, or non-specific documentation; as well as develop working relationship with operational leaders.
  • Perform and monitor all steps in the billing and coding process to ensure maximum reimbursement from patients, third-party payers as well as from special billing arrangements.
  • Develop, implement and oversee clinical provider and learner education performed by Trainer and Educational Liaison to ensure coding quality. Must have capacity to attend meetings day/evening as needed within assigned areas.
  • Participate in clinical huddles/didactics and other clinical meetings as requested.
  • Develop, implement and maintain billing and coding educational materials used in clinical provider and learner training, including the creation and ongoing maintenance of training protocol documents of the clinical workflow, including Medent usage.
  • Develop, implement and maintain population management learner training program addressing inpatient/outpatient chart review. Provide meaningful feedback and ongoing support and monitor to ensure residents have the knowledge needed.
  • Serve as resource and subject matter expert for all billing and coding matters.
  • Oversee and monitor the coding compliance program. Develop and coordinate educational and training programs regarding elements of the coding compliance such as appropriate documentation and accurate coding to all appropriate staff including coding staff, physicians, learners, other clinical providers and operational departments. Ensures the appropriate dissemination and communication of regulatory, policy and guideline changes.
  • Understand all aspects of Federally Qualified Health Center (FQHC) coverage, coding, billing and reimbursement of patient services, as well as other third-party payers.
  • Understand Medicare, Medicaid and other commercial payer rules and regulations applicable to billing/coding.
  • Understand the considerations of coding in Value Based payment contracts.
  • Follow coding/billing guidelines and legal requirements to ensure compliance with federal and state regulations.
  • Manage multiple priorities and projects with competing deadlines.
  • Serve as a coach and mentor for coding team. Assist team with projects as needed.
  • Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
  • Other duties as assigned by management.
Requirements REQUIRED QUALIFICATIONS
  • Bachelor or Associate degree in any Healthcare related field or equivalent experience.
  • Must be a Certified Professional Coder with 7-10 years minimum direct professional coding experience. Certified Professional Coder CPC, Certified Risk Adjustment Coder CRC (not required but a plus), Certified Professional Compliance Officer Certification - CPCO (not required but a plus).
  • Must have strong knowledge of all guidelines for ICD-10, CPT/HCPCS codes, medical terminology, and billing processes.
  • Knowledge of Medical Billing/EHR (Electronic Health Records) systems preferably Medent
  • Knowledge of EOBs (Explanation of Benefit), EFTs (Electronic Funds Transfer) and ERAs (Electronic Remittance Advice).
  • Knowledge of Microsoft Office software.
  • Must possess team leadership skills and have a positive disposition.
  • Must be focused, self-directed, & organized, with problem-solving abilities.
  • Accurate and precise attention to detail.
  • Excellent verbal and written communication skills.
REQUIRED LICENSES/CERTIFICATIONS
  • Certified Professional Coder-CPC
  • Certified Risk Adjustment Coder-CRC (not required but a plus)
  • Certified Professional Compliance Officer Certification - CPCO (not required but a plus)
PREFERRED QUALIFICATIONS
  • FQHC billing helpful (not required but a plus).
  • 5 to 7 year minimum experience managing staff within the patient revenue cycle.
  • General working knowledge/previous exposure of healthcare environments and auditing concepts, medical billing/operations, medical terminology and clinical documentation.

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