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Claims Representative Associate Jobs in West Virginia

Engle Martin & Associates

Is visible in their assigned territory to include insurance claims leaders, claims examiners ... Represents company at trade association meetings to promote products and services. * Delivers sales ...

Encova Insurance

Nurse Case Manager

Charleston, WV · On-site +1

$55K - $110K/yr

Salary The above represents the full salary range for this job requisition. Ultimately, in ... Claims. Are you a Referral? If you know a current Encova Insurance associate and would like to ...

Encova Insurance

Nurse Case Manager

Charleston, WV · On-site

$55K - $110K/yr

Salary The above represents the full salary range for this job requisition. Ultimately, in ... Claims. Are you a Referral? If you know a current Encova Insurance associate and would like to ...

Encova Insurance

Nurse Case Manager

Charleston, WV · On-site

$55K - $110K/yr

Salary The above represents the full salary range for this job requisition. Ultimately, in ... Claims. Are you a Referral? If you know a current Encova Insurance associate and would like to ...

Valley Health Care

Optician

Mill Creek, WV · On-site

$15 - $19.25/hr

Additional responsibilities may include managing inventory, processing insurance claims, and ... The requirements listed below are representative of the knowledge, skill, and/or ability required.

VALLEY HEALTH CARE INC

Optician

Mill Creek, WV · On-site

$15 - $19.25/hr

Additional responsibilities may include managing inventory, processing insurance claims, and ... The requirements listed below are representative of the knowledge, skill, and/or ability required.

Dasco HME LLC

Rehab Technician

Morgantown, WV · On-site

... claims * Completes projects, assignments, and other work duties as assigned. * Recommends ... The physical demands described here are representative of those that must be met by an associate to ...

Dasco HME LLC

Rehab Technician

Morgantown, WV · On-site

... claims * Completes projects, assignments, and other work duties as assigned. * Recommends ... The physical demands described here are representative of those that must be met by an associate to ...

Encova Insurance

Data Steward

Charleston, WV · On-site

$55K - $88K/yr

Salary The above represents the full salary range for this job requisition. Ultimately, in ... If you know a current Encova Insurance associate and would like to apply as a referral, please ...

Encova Insurance

Data Steward

Charleston, WV · Hybrid

$55K - $88K/yr

Salary The above represents the full salary range for this job requisition. Ultimately, in ... If you know a current Encova Insurance associate and would like to apply as a referral, please ...

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Showing results 21-40

All JobsClaims Representative Associate JobsClaims Representative Associate Jobs in West Virginia

Claims Representative Associate information

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

To thrive as a Claims Representative Associate, you need strong analytical skills, attention to detail, and knowledge of insurance policies, typically supported by a high school diploma or relevant work experience. Familiarity with claims management software, customer relationship management (CRM) systems, and basic office tools is essential. Excellent communication, problem-solving, and customer service skills help you effectively handle inquiries and resolve disputes. These skills ensure accurate claim processing, customer satisfaction, and efficient operations within the insurance industry.

What are some common challenges claims representative associates face when handling claims?

Claims Representative Associates often encounter challenges such as managing high caseloads, navigating complex policy details, and addressing discrepancies in documentation. Balancing efficiency with attention to detail is crucial, as errors can impact claim outcomes and customer satisfaction. Additionally, collaborating with policyholders, providers, and internal teams to resolve issues and provide clear communication requires strong interpersonal skills and resilience, especially when dealing with sensitive or disputed claims.

What is the difference between Claims Representative Associate vs Claims Adjuster?

AspectClaims Representative AssociateClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may prefer insurance licensesHigh school diploma; state licensing often required
Work EnvironmentOffice setting, customer service interactions, administrative tasksField or office, investigating claims, inspecting damages
Employer & Industry UsageInsurance companies, government agenciesInsurance companies, third-party administrators
Common Search & ComparisonClaims Representative Associate vs Claims Adjuster

The Claims Representative Associate typically handles customer inquiries, processes claims, and provides administrative support within insurance companies. In contrast, Claims Adjusters investigate claims, inspect damages, and determine claim validity. While both roles require similar credentials and work in the insurance industry, Claims Adjusters often have more technical responsibilities and fieldwork. Understanding these differences helps job seekers identify the right role based on their skills and career goals.

How much do claims representative associates make in the US?

Claims representative associates in the US typically earn an average annual salary of around $45,000 to $55,000, depending on experience, location, and employer. Entry-level positions may start lower, while experienced claims reps with specialized skills can earn higher wages and bonuses.

What do claims representative associates do?

Claims representative associates evaluate insurance claims by reviewing reports, documentation, and policy details to determine coverage and liability. They communicate with claimants, investigate claims, and process payments or denials, often using claims management software. Strong attention to detail and knowledge of insurance policies are essential for this role.

What are the most commonly searched types of Claims Representative jobs in West Virginia?

The most popular types of Claims Representative jobs in West Virginia are:

What are popular job titles related to Claims Representative Associate jobs in West Virginia?

For Claims Representative Associate jobs in West Virginia, the most frequently searched job titles are:

What job categories do people searching Claims Representative Associate jobs in West Virginia look for?

The top searched job categories for Claims Representative Associate jobs in West Virginia are:

What cities in West Virginia are hiring for Claims Representative Associate jobs?

Cities in West Virginia with the most Claims Representative Associate job openings:

Claims Representative Associate jobs near you
Infographic showing various Claims Representative Associate job openings in West Virginia as of July 2026, with employment types broken down into 1% As Needed, 67% Full Time, 29% Part Time, 1% Temporary, and 2% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution.

(Hybrid) Research Associate Analyst - Health Affairs Institute

West Virginia University

Charleston, WV • On-site

Full-time

Medical, Retirement, PTO

Re-posted 8 days ago

West Virginia University rating

6.9

Company rating: 6.9 out of 10

Based on 61 frontline employees who took The Breakroom Quiz

463rd of 631 rated colleges and universities

Job description

Description
The Health Affairs Institute at West Virginia University is currently accepting applications for a (Hybrid) Research Associate Analyst.
About the Opportunity
The Health Affairs Institute within the WVU Health Sciences Center provides organizational leadership for collaborative activities involving the Health Sciences Center, the West Virginia Department of Human Services (DoHS) and other partners. These include, among others, providing data analytic support, program evaluation expertise, technical assistance, and project management support for the DoHS and other partners. With office locations in both Morgantown and Charleston, the Health Affairs Institute (HAI) employs over 50 full-time staff and engages numerous faculty and staff from other units of the University to fulfill its service mission to the state.
The Research Associate in Health Data Analytics is a key participant in the State-University partnership between the West Virginia University Health Sciences Center and the DoHS. Overarching responsibilities include working with the state to leverage their data and support analytic and policy needs, conducting relevant policy and evaluation research, participating in interdisciplinary research and evaluation teams, and providing oversight of associated data analysts. The successful Research Associate in Health Data Analytics will be data-driven with strong analytical skills and a proven record of finding insights in disparate data and effectively communicating that information to drive decision making.
We strongly believe in work-life balance and keeping time for things we love outside our work. WVU offers generous benefits, including:
• 37.5-hour work week
• 13 paid holidays (staff holiday calendar)
• 24 annual leave (vacation) days per year (employee leave)
• 18 sick days per year (for when you're ill, for when you need time to care for sick family, for your own, or your family's, regularly scheduled medical appointments. Who is family for the purpose of this leave? A lot of people in your life including immediate relatives and in-laws as well as others considered to be members of your household living under the same roof)
• WVU offers a range of health insurance and other benefit
• 401(a) retirement savings with 6% employee contribution match, eligibility to continue health insurance, and other retiree perks. Looking for more retirement benefits information? Check out retirement health insurance benefits, retirement income, and FAQ's.
• Wellness program
What You'll Do
  • Utilizes expertise in machine learning and advanced statistical methods to analyze data sources such as Medicaid Claims to generate evidence for policy interventions.
  • Provide guidance to teams in optimal and proper use if Artificial Intelligence in data analytics
  • Oversees/provides mentorship other analysts as directed by the Director - Center for Measurement and Health Data Analytics
  • Oversees the analyst training program by identifying training gaps/requirements and collaborates with the HAI Program Development and Management Office (PDMO) to procure and/or develop and lead training modules as directed by the Center for Measurement and Health Data Analytics.
  • Leads data risk assessments to mitigate and/or expose data quality and/or security issues in collaboration with the PDMO and Director of Health Information.
  • Identifies and troubleshoots unanticipated data problems or unexpected results and provides solutions to resolve identified concerns.
  • Provides consultation, as needed, regarding optimal statistical methods and analysis designs.
  • Performs advanced statistical analysis with guidance from the Director - Center for Measurement and Health Data Analytics
  • Provides consultation and support for HAI project team members in data analysis and visualization best practices, and new and current technology.
  • Leads the development of detailed reports that can be readily understood, using best practices in data visualization and statistics.
  • Participates in high-level stakeholder meetings to understand stakeholder priorities and develop potential solutions as required.
  • Develops quality assurance processes and protocols in collaboration with the PDMO.
  • Conducts and overseas predictive data analytics using machine learning
  • Conducts and overseas geo-spatial analytics
  • Serves as an HAI representative and liaison to the DoHS for the planning and performance of projects, programs and activities involving health data analytics and program evaluation.
  • Facilitates communication and efficient collaboration between research partners at the Health Affairs Institute and the staff of the DoHS.
  • Ensures that data analytic and research/evaluation activities are compliant with Health Affairs Institute and University-level policies for the responsible conduct of research as well as federal, and state policies.
  • Provides consultation to faculty and government partners regarding preparation of research proposals, design and methodology, data analytics and interpretation of results.
  • Identifies opportunities for potential collaborations between the Health Sciences Center and the DoHS.
  • Prepares reports as required by the University, the Health Sciences Center administration, and external agencies. Communicates results of analytic projects and program evaluations with relevant staff of the DoHS.
  • Conducts or directs special projects as assigned. Acts in other matters and capacities as delegated by the Center for Measurement and Health Data Analytics for the Health Affairs Institute.

Qualifications
  • PhD in health-related field required.
  • A minimum of three (3) years of experience in the folllowing:
    • Record of research and achievement in health outcomes and policy research (health services research, public health informatics, health policy, clinical outcomes) as evidenced by publications and a sustained research program.
    • Experience in using Artificial Intelligence in data analytics
    • Experience and knowledge in predictive analytics using machine learning
    • Experience conducting research/evaluation within the academic and governmental sectors.
    • Good knowledge in Medicaid Claims data and adequate knowledge in medical coding.
    • Experience in conducting in-house training

Knowledge, Skills and Abilities
  • Extensive knowledge and experience in utilizing large health databases for research, program evaluation, and policy development.
  • Extensive knowledge in machine learning
  • Extensive knowledge in using Artificial Intelligence in data analytics
  • Ability to project and maintain a positive and collaborative attitude.
  • Record of accomplishments in the area of health data analytics.
  • Strong ability to communicate goals, methods, and results of research initiatives with key stakeholders.
  • Demonstrated proficiency in the use of standard software packages such as SAS or R
  • Good knowledge in handling mortality data
  • Experience working with Medicaid Claims data
  • Training and facilitation skills
  • Strong understanding of Data Security and Compliance - particularly with HIPAA and PHI data access and storage

  • Valid Driver's License and ability to travel on an intermittent basis if/when required.

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