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Claims Representative Associate Jobs in Chelsea, MA

W3Global Inc.

Regulatory Associate

Boston, MA · Remote

$235K - $310K/yr

This role provides the opportunity to work exclusively on health innovation , representing ... False Claims Act (FCA) * Fee-splitting laws * HIPAA * State healthcare privacy laws * Health data ...

Law Office of Daniel J. Moynihan PC

Be Seen First

Associate Attorney

Stoneham, MA · On-site

$70K - $80K/yr

... claims, labor and employment matters, and personal injury cases. The ideal candidate is a motivated ... Represent individuals and organizations in civil litigation, administrative proceedings, and ...

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All JobsClaims Representative Associate JobsClaims Representative Associate Jobs in Chelsea, MA

Claims Representative Associate information

See Chelsea, MA salary details

$14

$22

$33

How much do claims representative associate jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for claims representative associate in Chelsea, MA is $22.81, according to ZipRecruiter salary data. Most workers in this role earn between $18.56 and $25.10 per hour, depending on experience, location, and employer.

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 professionals or those with specialized skills can earn higher wages. Compensation often includes benefits such as health insurance and paid time off.

What do claims representative associates do?

Claims representative associates evaluate insurance claims by reviewing reports, policies, and evidence 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 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 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 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.

What are the most commonly searched types of Claims Representative jobs in Chelsea, MA? The most popular types of Claims Representative jobs in Chelsea, MA are:
What are popular job titles related to Claims Representative Associate jobs in Chelsea, MA? For Claims Representative Associate jobs in Chelsea, MA, the most frequently searched job titles are:
What job categories do people searching Claims Representative Associate jobs in Chelsea, MA look for? The top searched job categories for Claims Representative Associate jobs in Chelsea, MA are:
Claims Representative Associate jobs near you

Job Service Rep II

Department of Workforce Development

Boston, MA • On-site

$18.25 - $22.75/hr

Full-time

Re-posted 18 days ago

Job description

The Department of Family Medical Leave's (DFML) mission is to implement and run the Commonwealth's Paid Family & Medical Leave program, which provides income support to Massachusetts workers and their families during significant life events, while partnering with employers to ensure program integrity and compliance.
Lead Claims Examiner/Job Service Representative II, who reports to the Management Analyst III, is based in Boston, MA, and is responsible for the following:
  1. Supervise and provide day-to-day guidance to a team of JSRI, including workload oversight, performance support, and issue escalation.
  2. Facilitate the program integrity of the DFML by ensuring claims filed with the Department of Family and Medical Leave (DFML) are consistent with applicable laws, regulations and policies (M.G.L. Chapter 175M and 458 CMR 2.00)
  3. Investigate, analyze and respond to complex claims filed by claimants seeking DFML benefits that have been escalated from the call center and/or internal DFML departments and staff and research inconsistencies or omissions in reports generated by the agency and/or agency partners computer systems.
  4. Identify discrepancies or issues and escalate or remand to the appropriate internal department.
  5. Collect and review available data to identify, prioritize and resolve atypical eligibility issues.
  6. Review applicant data in cases where client eligibility or suitability is questionable or difficult to determine.
  7. Prepare accurate case notations within claims management system which contain accurate, specific, and sufficient facts to address the standards of the law and allow accurate application of law, regulation, and policy.
  8. Determine validity of information received through the Program Integrity's data match initiatives related to identity and eligibility, and issues written determinations on the same.
  9. Advise claimants and employers of appeal rights and procedures.
  10. Maintain relationships/contact with appropriate department personnel.
  11. Prepare reports, attend meetings and draft correspondence
  12. Assist in performing system testing / reporting as required
  13. Intake reports of potential fraud through the Department's Fraud Hotline.
  14. Analyze and investigate information received on employer information requests from employers.
  15. Process requests for hearings and escalate to internal DFML appeals.
  16. Performs related duties as required and assigned.

*This position follows a hybrid model and currently reports in office one day a week.
Qualifications:
First consideration will be given to those applicants that apply within the first 14 days. Minimum Entrance Requirements: Applicants must have (A) at least three (3) years of full time, or equivalent part-time professional or paraprofessional experience in personnel interviewing, vocational counseling, employment counseling, rehabilitation counseling, educational counseling, credit collection, credit interviewing, credit investigation, claims adjudication, claims settlement, claims examining, claims, investigation, claims interviewing, social work or social casework, or (B) any equivalent combination of the required experience and the substitutions below. Substitution: I. An Associate's degree may be substituted for one (1) year of the required experience. II. A Bachelor's degree or higher may be substituted two (2) years of the required experience. III. A Master's or higher degree may be substituted for the required experience.
Comprehensive Benefits
When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.
Want the specifics? Explore our Employee Benefits and Rewards!
An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.
The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.

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