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Claims Verification Specialist Jobs (NOW HIRING)

Verification Specialist Mooresville, NC Order: 250543 Core Duties * Product Verification * Confirm ... Work with customer service teams to verify warranty claims or product eligibility. * Communicate ...

Coverage Verification Specialist

Roslyn, NY · On-site

$17.50 - $21.50/hr

Process requests for claims histories and/or coverage verifications from brokers, insureds or third parties * Review requests for completeness, including proper authorization from insured(s), and ...

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Claims Verification Specialist information

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How much do claims verification specialist jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for claims verification specialist in the United States is $23.50, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $25.72 per hour, depending on experience, location, and employer.

What does a claims verification specialist do?

A Claims Verification Specialist is responsible for reviewing, verifying, and processing insurance claims to ensure their accuracy and compliance with company policies and legal regulations. They examine submitted documentation, contact claimants or providers for additional information, and determine the validity of claims before approval or denial. Their work helps prevent fraudulent claims and ensures that only eligible claims are paid, contributing to the financial integrity of the insurance company.

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

To thrive as a Claims Verification Specialist, you need strong attention to detail, analytical skills, and a background in insurance, finance, or a related field, often supported by a relevant degree or industry certification. Familiarity with claims management systems, data entry software, and sometimes regulatory compliance tools is typically required. Excellent communication, problem-solving, and organizational skills help specialists efficiently resolve discrepancies and interact with clients or colleagues. These skills are vital for ensuring accurate claim processing, minimizing errors, and maintaining trust with both clients and insurers.

What are the most common challenges faced by claims verification specialists, and how can they be effectively managed?

Claims Verification Specialists often encounter challenges such as managing high volumes of claims, detecting fraudulent activity, and ensuring compliance with regulatory requirements. Staying organized, utilizing advanced claims processing software, and maintaining strong attention to detail can help manage these demands. Effective communication with team members and other departments is also crucial for clarifying discrepancies and expediting the resolution of complex claims. Regular training on changing policies and fraud detection techniques further supports success in this role.

What is the difference between Claims Verification Specialist vs Claims Processor?

AspectClaims Verification SpecialistClaims Processor
CredentialsHigh school diploma or equivalent; certifications like CPC or similarHigh school diploma or equivalent; certifications often similar
Work EnvironmentInsurance companies, healthcare providers, or third-party administratorsInsurance companies, healthcare providers, or third-party administrators
Job FocusReviewing and verifying claim details for accuracy and completenessProcessing claims, entering data, and ensuring timely submission

The Claims Verification Specialist primarily reviews and verifies claim information for accuracy, while the Claims Processor handles the data entry and submission of claims. Both roles often work in similar environments and require comparable certifications, but their core responsibilities differ in focus and task execution.

More about Claims Verification Specialist jobs

What cities are hiring for Claims Verification Specialist jobs?

Cities with the most Claims Verification Specialist job openings:

What states have the most Claims Verification Specialist jobs?

States with the most job openings for Claims Verification Specialist jobs include:

Infographic showing various Claims Verification Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $48,885 per year, or $23.5 per hour.

EEOICPA Claims Processing and Verification Specialist

ProSidian Consulting

Richland, WA

$17.75 - $22/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 15 days ago


Job description

Company Description

ProSidian is looking for "Great People Who Lead" at all levels in the organization.  Are you a talented professional ready to deliver real value to clients in a fast-paced, challenging environment?  ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value.

ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management.  We help clients improve their operations.   

Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers.  Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information.

Job Description

ProSidian Seeks a EEOICPA Claims Processing and Verification Specialist located in The Hanford Tri-Cities Area (Kennewick | Pasco | Richland) to support an engagement for the US Dept. of Energy (DOE) Hanford in Eastern Washington (Tri-Cities - Kennewick | Pasco | Richland) Area. 

The ProSidian Engagement Team Members work to provide General Support Services Contractor (GSSC) assistance to support DOE Hanford [which consists of Richland Operations Office (RL), and Office of River Protection (ORP)] in support of the Govt's operations, personnel management, and general administration of regional operations at the Hanford Site in Richland, Washington. 

EEOICPA OP AB Support Candidates shall work to support requirements as a EEOICPA Claims Processing and Verification Specialist and support to the Energy Employees Occupational Illness Compensation Program (EEOICPA) Program Mgr.  across the U.S. Dept.  of Energy (DOE), Richland Operations Office (RL), Assistant Mgr.  for Mission Support (AMMS), Site Stewardship Division (SSD). EEOICPA Claims Processing and Verification Specialist shall provide staff to effectively support the EEOICPA Program Mgr.  in all phases of program implementation, including but not limited to managing all incoming and outgoing EEOICPA claims, preparing verifications of employment, and providing support for data capture requests from the National Institute of Occupational Safety and Health (NIOSH), Dept.  of Labor (DOL) and other involved parties.

DELIVERABLES

The EEOICPA Claims Processing and Verification Specialist shall provide support to the DOE-RL EEOICPA Program Mgr. . Such support shall include limited support to the DOE EEOICPA Program Mgr. , as requested, in support of the completion of DOE's requirements to support DOL and NIOSH during on-site data capture visits and in preparation for the data capture visits.  The ProSidian Engagement Team may be required to escort visitors to classified meetings, assist in documenting data captures, and providing other various administrative or basic technical support during these data capture visits, as directed by the EEOICPA Program Mgr.

Other direct support by definitive work category shall include:

  • Have the ability to review and analyze personnel records for relevant information, as well as skills at preparing summary documents, as requested.
  • After receipt of the information from others on site, ,EEOICPA Claims Processing and Verification Specialist shall compile the entire package including the employment verification prepared, evaluate it for completeness and process the claim to the requesting agents.
  • Ensure that these duties are performed in a competent, professional manner that meets established milestones and delivery schedules.
  • Work products are expected to be thorough, accurate, appropriately documented, and comply with mandated schedules.
  • Contacts with claimants or other EEOICPA related staff are expected to be of the highest competence and professionalism, recognizing the personal dynamics and issues of the claimants and other impacted personnel.

CLAIMS PROCESSING

  • Provide support on the day-to-day administration, management and tracking of all aspects of the EEOICPA claim process applicable to the Hanford and PNNL facilities and Hanford and PNNL employees.
  • Process all requests in a timely manner, as is within their scope of work and control.
  • Prepare reports, correspondence, copying, computer input, documentation as requested.
  • Communicate effectively with all Federal and contractor staff, as well as with all claimants that are in contact with the office.
  • Keep DOE-RL Program Mgr.  informed of work progress, new issues, concerns, or other items as appropriate.
  • Shipments and electronic downloads/uploads of claim related information shall be in accordance with the DOE-RL EEOICPA Program Mgr. ' s and DOE-HQ direction, policies and procedures
  • Provide routine monthly status reports and other reports as requested by the DOE-RL Program Mgr. . .
  • Conduct research to respond to inquiries from DOL and NIOSH relating to Hanford past practices or history to support claim development. These requests for research will be sporadic but require some specialized knowledge of Hanford's past contractor history.
  • Compile finding aids, as available, that document unusual sources of employment information, including historical lists of Hanford's contractors.  Manage that information collection in a secure and appropriate manner.

VERIFICATION OF EMPLOYMENT SUPPORT

  • Provide verification of employment reports on employees for former contractors, based on review and analysis of personnel records available. These verifications should include a narrative of the job title and work location, as well completion of the EE-5 forms required by Dept.  of Labor.

TECHNICIAN SUPPORT

  • Assist in logging documents/boxes into an established tracking system.
  • Move records boxes from one location in a work area to another to ensure the boxes are accurately staged for various work processes.
  • The ProSidian Engagement Team employee will scan personnel, medical or claim records from paper and electronic format and merge and consolidate the scanned files e-claim files.
  • The .contractor employee will provide typing, scanning, or records management support to EEOICPA claim and other EEOICPA related functions.
  • Create documents, lists or indices from various sources.
Qualifications

The EEOICPA Claims Processing and Verification Specialist shall have consecutive employment in a position with comparable responsibilities within the past five (5) years, Must be able to use a computer to communicate via email; and proficient in Microsoft Office Products (Word/Excel/Power point) and related tools and technology required for the position.

QUALIFICATIONS REQUIREMENTS

  • Depending on specific task assignments, certain permanent employees must have the ability to obtain a "Q" Clearance.
  • High school diploma required;
  • 6 years of relevant experience; and,
  • Contractor must be a U.S. citizen. 

TRAVEL:  Travel, both offsite and local onsite travel on the Hanford Site as coordinated with the EEOICPA Program Mgr.  and Contracting Officer is allowed, in accordance with the Federal Travel Regulations, on an as needed basis. Local travel on the Hanford Site is expected to facilitate the transfer of claim related or data capture related information.

LOCATION:  Work shall be conducted at the Dept.  of Energy - Richland Operations Office located in Richland, WA.

Additional Information

As a condition of employment, all employees are required to fulfill all requirements of the roles for which they are employed; establish, manage, pursue, and fulfill annual goals and objectives with at least three (3) Goals for each of the firms Eight Prosidian Global Competencies [1 - Personal Effectiveness | 2 - Continuous Learning | 3 - Leadership | 4 - Client Service | 5 - Business Management | 6 - Business Development | 7 - Technical Expertise | 8 - Innovation & Knowledge Sharing (Thought Leadership)]; and to support all business development and other efforts on behalf of ProSidian Consulting.  

CORE COMPETENCIES

  • Teamwork - ability to foster teamwork collaboratively as a participant, and effectively as a team leader
  • Leadership - ability to guide and lead colleagues on projects and initiatives
  • Business Acumen - understanding and insight into how organizations perform, including business processes, data, systems, and people
  • Communication - ability to effectively communicate to stakeholders of all levels orally and in writing
  • Motivation - persistent in pursuit of quality and optimal client and company solutions
  • Agility - ability to quickly understand and transition between different projects, concepts, initiatives, or work streams
  • Judgment - exercises prudence and insight in decision-making process while mindful of other stakeholders and long-term ramifications
  • Organization - ability to manage projects and activity, and prioritize tasks

------------ ------------ ------------

OTHER REQUIREMENTS

  • Business Tools -  understanding and proficiency with business tools and technology, including Microsoft Office. The ideal candidate is advanced with Excel, Access, Outlook, PowerPoint and Word, and proficient with Adobe Acrobat, data analytic tools, and Visio with the ability to quickly learn other tools as necessary.
  • Business Tools - understanding and proficiency with business tools and technology, including Microsoft Office. The ideal candidate is advanced with Excel, Access, Outlook, PowerPoint and Word, and proficient with Adobe Acrobat, data analytic tools, and Visio with the ability to quickly learn other tools as necessary.
  • Commitment - to work with smart, interesting people with diverse backgrounds to solve the biggest challenges across private, public and social sectors
  • Curiosity - the ideal candidate exhibits an inquisitive nature and the ability to question the status quo among a community of people they enjoy and teams that work well together
  • Humility - exhibits grace in success and failure while doing meaningful work where skills have impact and make a difference
  • Willingness - to constantly learn, share, and grow and to view the world as their classroom

------------ ------------ ------------

BENEFITS AND HIGHLIGHTS

ProSidian Employee Benefits and Highlights: Your good health and well-being are important to ProSidian Consulting. At ProSidian, we invest in our employees to help them stay healthy and achieve work-life balance. That's why we are also pleased to offer the Employee Benefits Program, designed to promote your health and personal welfare. Our growing list of benefits currently include the following for Full Time Employees:

  • Competitive Compensation: Pay range begins in the competitive ranges with Group Health Benefits, Pre-tax Employee Benefits, and Performance Incentives. For medical and dental benefits, the Company contributes a fixed dollar amount each month towards the plan you elect. Contributions are deducted on a Pre-tax basis.
  • Group Medical Health Insurance Benefits: ProSidian partners with BC/BS, to offer a range of medical plans, including high-deductible health plans or PPOs. ||| Group Dental Health Insurance Benefits: ProSidian dental carriers - Delta, Aetna, Guardian, and MetLife.
  • Group Vision Health Insurance Benefits:ProSidian offers high/low vision plans through 2 carriers: Aetna and VSP.
  • 401(k) Retirement Savings Plan: 401(k) Retirement Savings Plans help you save for your retirement for eligible employees. A range of investment options are available with a personal financial planner to assist you. The Plan is a pre-tax Safe Harbor 401(k) Retirement Savings Plan with a company match.
  • Vacation and Paid Time-Off (PTO) Benefits: Eligible employees use PTO for vacation, a doctor's appointment, or any number of events in your life. Currently these benefits include Vacation/Sick days - 2 weeks/3 days | Holidays - 10 ProSidian and Government Days are given.
  • Pre-Tax Payment Programs: Pre-Tax Payment Programs currently exist in the form of a Premium Only Plan (POP). These Plans offer a full Flexible Spending Account (FSA) Plan and a tax benefit for eligible employees.
  • Purchasing Discounts & Savings Plans: We want you to achieve financial success. We offer a Purchasing Discounts & Savings Plan through The Corporate Perks Benefit Program. This provides special discounts for eligible employees on products and services you buy on a daily basis.
  • Security Clearance: Due to the nature of our consulting engagements there are Security Clearance requirements for Engagement Teams handling sensitive Engagements in the Federal Marketplace. A Security Clearance is a valued asset in your professional portfolio and adds to your credentials.
  • ProSidian Employee & Contractor Referral Bonus Program: ProSidian Consulting will pay up to 5k for all referrals employed for 90 days for candidates submitted through our Referral Program.
  • Performance Incentives: Due to the nature of our consulting engagements there are performance incentives associated with each new client that each employee works to pursue and support.
  • Flexible Spending Account: FSAs  help you pay for eligible out-of-pocket health care and dependent day care expenses on a pre-tax basis. You determine your projec...

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About ProSidian Consulting

Sourced by ZipRecruiter

ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers. Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/ProSidianfor more information.

Industry

Business schools and computer and management training

Company size

11 - 50 Employees

Headquarters location

Charlotte, NC, US

Year founded

2004

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