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Claims Processor Jobs in Springfield, IL (NOW HIRING)

Sedgwick

Primary Casualty Adjuster

Springfield, IL · On-site

Delivers an exceptional level of customer service throughout the entire claims process * Evaluates coverage and drafts coverage letters to include both reservations of rights and coverage denials

Memorial Health

Medicaid Specialist

Springfield, IL · On-site

$18.34 - $28.42/hr

Prioritizes claims based on specified criteria and electronically files the claim, ensuring careful adherence to Medicaid guidelines, timeliness, accuracy, and processing procedures. At prescribed ...

Memorial Health

Medicaid Specialist

Springfield, IL · Remote

$18.34 - $28.42/hr

Prioritizes claims based on specified criteria and electronically files the claim, ensuring careful adherence to Medicaid guidelines, timeliness, accuracy, and processing procedures. At prescribed ...

Memorial Health

Medicaid Specialist

Springfield, IL · Remote

$18.34 - $28.42/hr

Prioritizes claims based on specified criteria and electronically files the claim, ensuring careful adherence to Medicaid guidelines, timeliness, accuracy, and processing procedures. At prescribed ...

Springfield Clinic

Insurance Reviewer II

Springfield, IL · On-site

$18.22 - $26.42/hr

Process designated insurance reviews when requested to obtain additional payments on claims utilizing websites or telephone as necessary. Analyze and process front-end system edits for correct ...

Springfield Clinic

Insurance Reviewer II

Springfield, IL · On-site

$18.22 - $26.42/hr

Process designated insurance reviews when requested to obtain additional payments on claims utilizing websites or telephone as necessary. Analyze and process front-end system edits for correct ...

Aon

Account Executive II, Construction

Springfield, IL · On-site

$150K - $195K/yr

Skills And Experience That Will Lead To Success Strong professional background in client services leadership, process improvement, and innovative problem‐solving. Deep claims acumen across workers ...

Memorial Health

Follow-Up Specialist

Springfield, IL · On-site

$18.34 - $28.42/hr

Possesses the technical knowledge to independently process claims of any denomination, type, and complexity is required. Other Knowledge/Skills/Abilities: * Demonstrates thorough knowledge of the ...

Memorial Health

Follow-Up Specialist

Springfield, IL

$18.34 - $28.42/hr

Possesses the technical knowledge to independently process claims of any denomination, type, and complexity is required. Other Knowledge/Skills/Abilities: * Demonstrates thorough knowledge of the ...

Memorial Health

Follow-Up Specialist

Springfield, IL

$18.34 - $28.42/hr

Possesses the technical knowledge to independently process claims of any denomination, type, and complexity is required. Other Knowledge/Skills/Abilities: * Demonstrates thorough knowledge of the ...

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How much do claims processor jobs pay per hour?

As of Jun 5, 2026, the average hourly pay for claims processor in Springfield, IL is $18.99, 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 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 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.

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.

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.

What is the qualification for claims processor?

A claims processor typically needs a high school diploma or equivalent, strong attention to detail, good organizational skills, and familiarity with claims processing software. Some employers may prefer candidates with prior experience in insurance or customer service, and certifications such as the Certified Claims Professional (CCP) can be advantageous.

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.

More about Claims Processor jobs
What are the most commonly searched types of Claims Processor jobs in Springfield, IL? The most popular types of Claims Processor jobs in Springfield, IL are:
What are popular job titles related to Claims Processor jobs in Springfield, IL? For Claims Processor jobs in Springfield, IL, the most frequently searched job titles are:
What job categories do people searching Claims Processor jobs in Springfield, IL look for? The top searched job categories for Claims Processor jobs in Springfield, IL are:
What cities near Springfield, IL are hiring for Claims Processor jobs? Cities near Springfield, IL with the most Claims Processor job openings:
Claims Processor jobs near you
Error Resolution Section Manager (SPSA)

Error Resolution Section Manager (SPSA)

State of Illinois

Springfield, IL • On-site, Remote

$10K - $12K/mo

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

State Of Illinois rating

7.8

Company rating: 7.8 out of 10

Based on 72 frontline employees who took The Breakroom Quiz

20th of 50 rated states

Job description

Job Requisition ID: 56251 
BPIS: 10179

Opening Date: 06/02/2026
Closing Date: 06/16/2026
Agency:Department of Healthcare and Family Services
Class Title: SENIOR PUBLIC SERVICE ADMIN (40070) 
Skill Option: General Administration/Business Marketing/Labor/Personnel 
Bilingual Option: None
Salary: Anticipated starting salary: $10,500 - $12,500/mo
Job Type: Salaried
Category: Full Time 
County: Sangamon
Number of Vacancies: 1
Bargaining Unit Code: None
Merit Comp Code: Federally Funded, Gubernatorial (Management Bill) Exclusion from Collective Bargaining Coverage


A resume is highly encouraged to evaluate your qualifications and skills as part of your application.  Please attach a DETAILED Resume/Curriculum Vitae (CV) to the MY DOCUMENTS section of your application if you decide to provide one.

Why Work for Illinois?

Working with the State of Illinois is a testament to the values of compassion, equity, and dedication that define our state. Whether you're helping to improve schools, protect our natural resources, or support families in need, you're part of something bigger-something that touches the lives of every person who calls Illinois home.

No matter what state career you're looking for, we offer jobs that fit your life and your schedule-flexible jobs that provide the gold standard of benefits. Our employees can take advantage of various avenues to advance their careers and realize their dreams. Our top-tier benefits and great retirement packages can help you build a rewarding career and lasting future with the State of Illinois.

Position Overview:

The Department of Healthcare and Family Services, dedicated to improving lives for Illinoisans, is seeking to hire a highly motivated, qualified individual as a Senior Public Service Administrator who will serve as the Bureau of Claims Processing, Error Resolution Section Manager.  The ideal candidate will demonstrate an overall strong skill set that will ensure the Bureau of Claims Processing maintains the highest level of standards in all operations within the Bureau, particularly in processing medical claim documents for timely payments to the provider community, online correction and utilization review of provider submitted invoices for proper payment adjudication.  The ideal candidate will demonstrate their dedication to teamwork, the ability to work in a fast-paced, ever-changing environment, a strong supervisory background, including experience managing a large staff, knowledge of the Department's goals and objectives, knowledge and experience managing large scale processing operations, and the desire to promote and provide quality services on behalf of the State of Illinois.  We invite qualified candidates to consider joining the Bureau of Claims Processing team to continue the overall mission of the Department of Healthcare and Family Services.

HFS values employees with different backgrounds, life experiences, and talents. 

Employees receive a robust benefit package including:

  • Monday-Friday work schedule
  • Flexible work schedules are available in many program areas. (Remote work may be an option for certain positions.)
  • Health, Life, Vision, and Dental Insurance
  • Pension Plan
  • Paid Parental Leave
  • Deferred Compensation Program and other pre-tax benefit programs (Medical/Daycare)
  • Employees earn (12) paid Sick Days annually.
  • New Employees earn (10) paid Vacation Days their first year of service and can earn up to (25) paid Vacation Days annually.
  • Employees earn (3) paid Personal Days annually.
  • (13-14) paid holidays annually (based on start date)

If you are seeking a new opportunity, and this position appeals to you, please apply today!

At the Illinois Department of Healthcare and Family Services (HFS), we value staff as our greatest asset. We work in a spirit of teamwork to help millions of Illinoisans access high quality healthcare and fulfill child support obligations to advance their physical, mental, and financial well-being. We provide healthcare coverage for children and adults through Medicaid and other medical programs, and we help ensure that children receive financial resources from both their parents through Child Support Services. The HFS Office of the Inspector General investigates, audits and reviews program activity to ensure the integrity of our programs is maintained.

HFS is committed to promoting and preserving a workplace culture that embraces diversity, equity, and inclusion.  We welcome and value employees with different backgrounds, life experiences, and talents.  It is the collective sum of our individual differences that provides a broad perspective, leading to greater innovation and achievement.  In recruiting for our team, we recognize the unique contributions of each applicant regardless of culture, ethnicity, race, national origin, sex, gender identity and expression, age, religion, disability, and sexual orientation. HFS is an equal opportunity employer.

Essential Functions
  • Subject to management approval, serves as the Error Resolution Section Manager by planning, developing, and managing the operations of the Error Resolution Section relating to the adjudication and maintenance of medical invoices submitted in accordance with the Medicaid Program, as well as the pricing and prepay processes, special processing of newborn invoices, online-correction processes of Institutional and non-institutional claims with or without attachments, including Medicare crossover claims
  • Serves as full line supervisor
  • Directs the operation of corrections processing for adjudication of medical invoices through the Department's Medicaid Management Information System (MMIS), special processing of newborn invoices, processing of electronic claim submissions with and without attachments for all claim types, review and processing preparation of claims with attachments requiring review, including, but not limited to, hysterectomy and sterilization forms, general and post general mode reports, reject and aged document reports, on line correction processing of all hard copy and electronic claims types for institutional and non-institutional invoices with and without attachments, including Medicare Crossover invoices and the Pricing and Prepay utilization review processes
  • Directs the management of the Pricing/Prepay Unit, Special Program Review Unit, On-line Corrections Unit and Medicare unit on the integration of program activities to resolve administrative, policy and procedural issues
  • Consults with management on the integration of program activities
  • Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above
Minimum Qualifications
  • Requires knowledge, skill, and mental development equivalent to completion of four (4) years of college
  • Requires prior experience equivalent to four (4) years of progressively responsible administrative experience in a public or business organization
Preferred Qualifications
  • Minimum of four (4) years of experience supervising professional staff in an office setting
  • Minimum of four (4) years of professional experience directing the processing of medical claims and payments for a public or private organization
  • Minimum of three (3) years of professional experience working with on-line claim processing and/or data claim processing
  • Minimum of three (3) years of professional experience developing and implementing program and operational policies and procedures
  • Minimum of three (3) years of professional experience researching and analyzing large sets of claims data
  • Minimum of three (3) years of professional experience communicating with stakeholders at all levels within an organization
  • Minimum of two (2) years of experience working with Microsoft Excel to maintain complex spreadsheets and track daily tasks 
  • Licensure in one of the following specialties: Registered Nurse, Licensed Practical Nurse, Speech/Language Pathologist, Respiratory Therapist, Physical Therapist or Occupational Therapist
  • Minimum of one (1) year of experience providing supporting documentation for deposition and/or testimony in a State or Federal court of law
Conditions of Employment
  • Requires completion of a background check and self-disclosure of criminal history
  • Requires the ability to travel in the performance of duties, with overnight stays as appropriate
  • Requires the ability to utilize and maintain state issued equipment such as a laptop
  • This position has been found to meet the requirements in section 4A-101 of the Illinois Governmental Ethics Act requiring the occupant/employee to file a Statement of Economic Interest. The Illinois Governmental Ethics Act (5 ILCS 420/4A et seq.) requires certain state officials and employees to file annual Statements of Economic Interest with the Office of the Secretary of State that will be made available for examination and copying by the public. All employees required to file a Statement of Economic Interest are also required to file the Supplemental Statement of Economic Interest with the Executive Ethics Commission. (See Executive Order 15-09) Fines and penalties apply to untimely filings
  • The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job description

Work Hours:  Monday - Friday 8:30 am - 5:00 pm 
Headquarter Location: 201 S Grand Ave E, Springfield, Illinois, 62704 
Work County: Sangamon
Agency Contact: HFS.DMPApps@illinois.gov
Posting Group: Leadership & Management

Statement of Economic Interest:

This position has been found to meet the requirements in section 4A-101 of the Illinois Governmental Ethics Act requiring the occupant/employee to file a Statement of Economic Interest. The Illinois Governmental Ethics Act (5 ILCS 420/4A et seq.) requires certain state officials and employees to file annual Statements of Economic Interest with the Office of the Secretary of State that will be made available for examination and copying by the public. All employees required to file a Statement of Economic Interest are also required to file the Supplemental Statement of Economic Interest with the Executive Ethics Commission. (See Executive Order 15-09) Fines and penalties apply to untimely filings. 

The main form of communication will be through email. Please check your "junk mail", "spam", or "other" folder for communication(s) regarding any submitted application(s). You may receive emails from the following addresses:

  • donotreply@SIL-P1.ns2cloud.com
  • systems@SIL-P1.ns2cloud.com

What State Of Illinois employees say

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About State of Illinois

Sourced by ZipRecruiter

The State of Illinois is not a traditional company, but rather a governmental entity encompassing diverse agencies and departments that serve the constituents of Illinois. Based in Illinois, United States, this governmental body communicates with its citizens through the official website illinois.gov. The website is a one-stop resource for Illinois residents to access information about the state's services, including education, healthcare, transportation, and public safety, among others.

Company size

11 - 50 Employees

Headquarters location

Springfield, IL, US

Year founded

2009

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