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Disability Claims Processor Jobs in Georgia (NOW HIRING)

HealthONE

Claims Processor II

Dalton, GA · On-site

$15 - $19/hr

Claims Processor II Our mission is to enhance well-being by connecting individuals with vital ... Short Term Disability * Vision Insurance Pre-Employment Screening: Drug Screen and Background Check ...

HealthOne Alliance

Claims Processor II

Dalton, GA · On-site

$15 - $19/hr

JOB PURPOSE The Claims Processor II is responsible for accurate and timely processing of both ... D Insurance Long Term Disability Medical Insurance Paid Time Off Pet Insurance Short Term ...

HealthOne Alliance

Claims Processor II

Dalton, GA · On-site

$15 - $19/hr

JOB PURPOSE The Claims Processor II is responsible for accurate and timely processing of both ... D Insurance Long Term Disability Medical Insurance Paid Time Off Pet Insurance Short Term ...

HealthOne Alliance

Claims Processor II

Dalton, GA

$15 - $19/hr

JOB PURPOSEThe Claims Processor II is responsible for accurate and timely processing of both ... disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender ...

The Hartford

Long Term Disability Analyst

Alpharetta, GA · On-site +1

$10K/mo

Investigate and manage longterm disability claims by gathering and evaluating information from ... Guide customers through the disability and recovery process, focusing on functional abilities ...

Robert Half

Case Manager

Atlanta, GA · On-site

$19.25 - $24.75/hr

... claims and appeals process. This role involves client communication, file management, records ... Experience with Social Security Disability or Veterans Disability claims preferred * Strong ...

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All JobsDisability Claims Processor JobsDisability Claims Processor Jobs in Georgia

Disability Claims Processor information

What does a disability claims processor do?

A Disability Claims Processor reviews and evaluates disability insurance claims to determine whether applicants are eligible for benefits. They analyze medical records, employment history, and other relevant documentation to make informed decisions in accordance with policy guidelines and legal regulations. These professionals communicate with claimants, healthcare providers, and employers to gather necessary information and explain claim decisions. Their goal is to ensure accurate, timely, and fair processing of disability claims.

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

To thrive as a Disability Claims Processor, you need strong analytical skills, attention to detail, and a solid understanding of insurance regulations, often supported by a background in business, healthcare, or insurance. Familiarity with claims management systems, medical terminology, and relevant software like MS Office or specialized claims platforms is typically required. Excellent communication, empathy, and problem-solving abilities are important soft skills for working with claimants and coordinating with medical professionals. These competencies ensure accurate, timely claims processing while maintaining compliance and delivering compassionate service to clients.

What are some common challenges faced by disability claims processors, and how can applicants prepare for them?

Disability Claims Processors often encounter challenges such as managing a high volume of complex cases, interpreting medical and legal documentation, and maintaining compliance with evolving regulations. Applicants can prepare by developing strong organizational skills, attention to detail, and the ability to communicate clearly with claimants, healthcare providers, and legal professionals. Familiarity with specialized claims processing software and a willingness to stay updated on policy changes will also help new hires succeed in this dynamic role.

What is the difference between Disability Claims Processor vs Disability Claims Examiner?

AspectDisability Claims ProcessorDisability Claims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require insurance or healthcare certificationsBachelor's degree often preferred; certifications in insurance or healthcare are common
Work EnvironmentOffice setting, processing claims, data entry, customer communicationOffice or government agency, reviewing detailed claims and medical documentation
Employer & Industry UsageInsurance companies, government agencies, third-party administratorsInsurance companies, government disability programs, healthcare organizations
Common Search & ComparisonYesYes

Disability Claims Processors primarily handle the initial processing of disability claims, focusing on data entry and customer communication. Disability Claims Examiners review detailed medical documentation and make determinations on claim validity. While both roles work within the disability insurance industry and require similar credentials, Examiners typically have more in-depth review responsibilities and may require higher education or certifications.

How to get a job as a disability claims processor?

To become a disability claims processor, candidates typically need a high school diploma or equivalent, with some roles preferring post-secondary education or relevant experience. Strong organizational skills, attention to detail, and familiarity with claims processing software are important. Certification in claims or insurance processing can enhance job prospects, and positions often require working in an office environment with standard business hours.

Is claims processing a stressful job?

Disability claims processing can be stressful due to the need for accuracy, attention to detail, and meeting deadlines. The role often involves handling sensitive information and managing a high volume of cases, which can contribute to work-related stress. However, workload and stress levels vary depending on the employer and individual workload management skills.

Who processes disability claims?

Disability claims are processed by claims processors or adjudicators working for government agencies, insurance companies, or third-party administrators. These professionals review medical records, application forms, and supporting documentation to determine eligibility based on policy or program criteria, often using specialized software and adhering to regulatory guidelines.

What are popular job titles related to Disability Claims Processor jobs in Georgia?

For Disability Claims Processor jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Disability Claims Processor jobs in Georgia look for?

The top searched job categories for Disability Claims Processor jobs in Georgia are:

Disability Claims Processor jobs near you
Infographic showing various Disability Claims Processor job openings in Georgia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 60% In-person, and 40% Remote job distribution.

Claims Processor II

HealthONE

Dalton, GA • On-site

$15 - $19/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 7 days ago

Job description

Claims Processor II

Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors. HealthOne is guided by a cultural framework that embodies our values and drives our decisions. As a company our purpose is to care for people by connecting them to resources that help protect them in health related situations. We fulfill our purpose by filtering our decisions through a lens of asking, "Is what we are about to do ethical, empathetic, economical, and efficient?". By caring for people, we are welcoming, authentic, truthful, consistent, and humble. We are continuously looking for ways to improve our process and how we get things done. HealthOne seeks individuals with integrity and heart to embody our values. Whether you're starting your career or looking to develop additional skills to reach your full potential, HealthOne provides the means to help you achieve your goals.

Job Purpose: The Claims Processor II is responsible for accurate and timely processing of both professional and institutional medical claims pended for manual adjudication in assigned Workflow roles. The Claims Processor II will accurately interpret benefit and policy provisions applicable to fully-insured plan members and review claims to determine coverage based on contract, provider status, and claims processing guidelines. The incumbent must meet quality and productivity standards.

Essential Job Duties:

  • Reviews and adjudicates claims up to specified dollar limits
  • Processes claims within performance guidelines of the department, including quality and timeliness
  • Works with and understands Company benefit plans
  • Understands provider contracts
  • Examines and interprets all relevant documents included with the claims
  • Responds to claim-specific questions, as applicable
  • Partners with leadership on any questionable claim activity
  • Understands logic of standard medical coding (i.e. CPT, ICD-10, HCPCS, etc.)
  • Determines accurate payment criteria for clearing pended claims based on defined Policy and Procedures
  • Researches claim edits to determine appropriate benefit application utilizing established criteria, applies physician contract pricing as needed for claims
  • Works high volume of repetitive claims
  • Identifies claims with inaccurate data or claims that require review by appropriate team members
  • Contributes positively as a team player
  • Completes special projects as assigned and supports other Claims Department team members in assigned projects
  • Complies with all departmental and Company policies and procedures
  • Maintains regular and predictable attendance
  • Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
  • Works to encourage and promote Company culture throughout the organization
  • Other duties as may be assigned

Qualifications:

  • High School Diploma or GED required
  • Associates or Bachelor's Degree preferred
  • A minimum of one year experience in claims processing required, must include Professional and Institutional processing; previous experience in medical billing and coding required if no claims processing experience
  • Knowledge of ICD-10, CPT4, DRG, HCPCS codes, medical terminology, EDI and HIPAA protocols preferred
  • Knowledge of UB and HCFA 1500 forms
  • Certified Professional Coder (CPC) preferred
  • Experience with Word and Excel

Physical Requirements:

  • Prolonged periods of sitting at a desk and working on a computer
  • Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities
  • Must be able to drive a vehicle and daytime/overnight travel as required

Benefits:

  • 401K (4% Match, Immediate Vesting)
  • Accident insurance
  • Competitive salary
  • Critical Illness Insurance
  • Dental Insurance
  • Employee Assistance Program
  • Flexible Spending Account
  • Health & Wellness Program
  • Health Savings Account
  • Life & AD&D Insurance
  • Long Term Disability
  • Medical Insurance
  • Paid Time Off
  • Pet Insurance
  • Short Term Disability
  • Vision Insurance

Pre-Employment Screening: Drug Screen and Background Check Required

HealthOne is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status or any other status protected by state or federal law.

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