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Health Insurance Claims Processor Jobs in Kentucky

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · Remote

$15.50 - $19.75/hr

Health, Dental, Vision, and Life Insurance * Company-Paid Disability Insurance * Tuition Assistance ... claims, billing and insurance processing. Pharmacy Technician experience and/or knowledge of ...

BrightSpring

Pharmacy Claims Processor / Remote

Louisville, KY · Remote

$15.50 - $19.75/hr

Health, Dental, Vision, and Life Insurance * Company-Paid Disability Insurance * Tuition Assistance ... claims, billing and insurance processing. Pharmacy Technician experience and/or knowledge of ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

Health, Dental, Vision, and Life Insurance * Company-Paid Disability Insurance * Tuition Assistance ... claims, billing and insurance processing. Pharmacy Technician experience and/or knowledge of ...

Firstsource

Claims Examiner

Louisville, KY · On-site

$17/hr

Health Plan and Healthcare Services Reporting to: Team Lead/Supervisor - Operations Pay Rate: $17 ... Ensure that claims processing aligns with the company's insurance policies and relevant regulatory ...

Sutherland

Health Claims Specialists

Louisville, KY · On-site

$13.50/hr

A claims adjudicator determines how much money will be paid after an insurance claim has been ... Work independently, processing claims via data entry for 90% of your day. * Be responsible for ...

Sutherland

Health Claims Specialists

Louisville, KY · On-site +1

$13.50/hr

A claims adjudicator determines how much money will be paid after an insurance claim has been ... Work independently, processing claims via data entry for 90% of your day. * Be responsible for ...

Firstsource

Claims Examiner

Louisville, KY · On-site

$17 - $20/hr

... Care, Health Insurance, Third-Party Administration (TPA), or Healthcare Business Process ... Claims Processing * Appeals & Grievance Administration * Claims Investigation * Healthcare ...

TEKsystems

Claims Specialist

Lexington, KY

$15 - $16/hr

... in insurance and claims operations. The Claims Support Specialist will serve as a key point of ... Process incoming claims information and enter new loss reports into company systems. * Update ...

TEKsystems

Claims Specialist

Lexington, KY

$15 - $16/hr

... in insurance and claims operations. The Claims Support Specialist will serve as a key point of ... Process incoming claims information and enter new loss reports into company systems. * Update ...

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All JobsHealth Insurance Claims Processor JobsHealth Insurance Claims Processor Jobs in Kentucky

Health Insurance Claims Processor information

See Kentucky salary details

$10

$19

$29

How much do health insurance claims processor jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for health insurance claims processor in Kentucky is $19.40, according to ZipRecruiter salary data. Most workers in this role earn between $15.87 and $22.12 per hour, depending on experience, location, and employer.

What is the difference between Health Insurance Claims Processor vs Medical Billing Specialist?

AspectHealth Insurance Claims ProcessorMedical Billing Specialist
CredentialsHigh school diploma; certifications like Certified Claims Professional (CCP)High school diploma; certifications like Certified Medical Billing Specialist (CMBS)
Work EnvironmentInsurance companies, healthcare providers, claims departmentsMedical offices, billing companies, healthcare facilities
Primary ResponsibilitiesReview and process insurance claims, ensure accuracy, follow up on denialsPrepare and submit medical bills, verify insurance coverage, manage patient accounts

While both roles involve handling healthcare financial transactions, the Health Insurance Claims Processor primarily focuses on reviewing and processing insurance claims submitted by providers, whereas the Medical Billing Specialist manages the billing process from patient registration to payment collection. Both roles require knowledge of insurance policies and coding, but their daily tasks and work environments differ slightly.

Is a health insurance claims processor job in demand?

Health insurance claims processor jobs are in steady demand due to the ongoing need for healthcare administration and insurance processing. Employment in this field is expected to grow as healthcare coverage expands and companies seek skilled workers familiar with claims software and regulations.

What does a health insurance claims processor do?

A Health Insurance Claims Processor reviews and evaluates insurance claims submitted by policyholders or healthcare providers. They verify the accuracy of the information, ensure that the claims comply with policy terms, and determine the amount payable for each claim. Claims processors may also correspond with providers or claimants for additional documentation, resolve discrepancies, and help prevent fraudulent claims. Their work ensures that claims are processed efficiently and payments are made accurately according to insurance policies.

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

To thrive as a Health Insurance Claims Processor, you need attention to detail, knowledge of insurance policies and medical terminology, and typically a high school diploma or equivalent. Familiarity with claims management software, electronic health record (EHR) systems, and basic coding (ICD-10, CPT) is standard in this role. Strong organizational skills, problem-solving abilities, and effective communication help you manage claims efficiently and resolve discrepancies. These competencies ensure accurate processing, minimize errors, and support timely reimbursement within the healthcare system.

How to become a health insurance claims processor?

To become a health insurance claims processor, candidates typically need a high school diploma or equivalent and should develop skills in data entry, attention to detail, and knowledge of insurance policies. Some employers prefer candidates with postsecondary education or certifications in health insurance or medical billing, and on-the-job training is common. Proficiency with claims processing software and understanding of healthcare terminology are also beneficial.

What are some common challenges health insurance claims processors face, and how can they effectively manage them?

Health Insurance Claims Processors often encounter challenges such as interpreting complex policy language, managing high volumes of claims, and ensuring compliance with changing regulations. To effectively manage these challenges, processors benefit from developing strong attention to detail, staying up to date with industry guidelines, and utilizing time management strategies. Collaboration with other departments such as customer service and medical coding teams is also key to resolving discrepancies and ensuring accurate claim outcomes.
What are popular job titles related to Health Insurance Claims Processor jobs in Kentucky? For Health Insurance Claims Processor jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Health Insurance Claims Processor jobs in Kentucky look for? The top searched job categories for Health Insurance Claims Processor jobs in Kentucky are:
Health Insurance Claims Processor jobs near you
Infographic showing various Health Insurance Claims Processor job openings in Kentucky as of July 2026, with employment types broken down into 1% As Needed, 76% Full Time, 19% Part Time, and 4% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $40,353 per year, or $19.4 per hour.

Pharmacy Claims Processor / Remote

BrightSpring Health Services

Louisville, KY • On-site

$16.25 - $20.75/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 22 days ago

BrightSpring Health Services rating

4.8

Company rating: 4.8 out of 10

Based on 62 frontline employees who took The Breakroom Quiz

220th of 239 rated social care providers

Job description

Pharmacy Claims Processor / Remote
Job Locations US-KY-LOUISVILLE
ID 2026-191701 Line of Business PharMerica Position Type Full-Time
Our Company

PharMerica

Overview

Step Into a Rewarding Role as an LTC Pharmacy Claims Specialist with PharMerica!

Are you ready to make a real impact in a growing organization? Join our PharMerica team as a Claims Specialist, where you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy environment, allowing you to focus on what truly matters-delivering exceptional care and service.

Why Join PharMerica?

    Focused on Service Excellence: Our mission is to provide top-quality care and outstanding customer service to hospitals, rehabilitation centers, long-term acute care hospitals, and specialized care centers across the nation.
  • Career Growth: We're in high growth mode, offering plenty of opportunities for those looking to advance their careers.
  • Remote Flexibility: This position is 100% remote, giving you the freedom to work from anywhere!

What You'll Do: As a dynamic Claims Specialist, you will:

  • Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need.
  • Be a vital part of a team that's dedicated to enhancing patient care through meticulous claims management and customer service.

Shift: Varying shifts available from 4:30am-12:00am. Overnight & Weekend shifts required.

Must have pharmacy claims or adjudication background.

What We Offer:

  • DailyPay
  • Flexible Schedules
  • Competitive Pay with Shift Differentials
  • Health, Dental, Vision, and Life Insurance
  • Company-Paid Disability Insurance
  • Tuition Assistance & Reimbursement
  • Employee Discount Program
  • 401k Plan
  • Paid Time Off
  • Non-Retail, Closed-Door Environment
Responsibilities

The Claims Specialist - 3rd Party:

  • Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks
  • Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines
  • Ensures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement
  • Monitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processes
  • Works as a team to identify, document, communicate and resolve payer/billing trends and issues
  • Reviews and works to convert billing exception reports to ensure claims are billed to accurate financial plans
  • Prepares and maintains reports and records for processing
  • Performs other tasks as assigned
Qualifications

Education/Learning Experience:

  • Required: High School Diploma or GED
  • Desired: Associate's or Bachelor's Degree

Work Experience:

  • Required: Customer Service
  • Desired: Up to one year of related experience. Pharmacy Technician experience

Skills/Knowledge:

  • Required: Ability to retain a large amount of information and apply that knowledge to related situations. Ability to work in a fast-paced environment. Basic math aptitude. Microsoft Office Suite
  • Desired: Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations and trendsetters

Licenses/Certifications:

  • Desired: Pharmacy technician, but not required
About our Line of Business
PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.
Additional Job Information

This is an excellent opportunity to move from a retail to office environment for those who are willing to learn claims, billing and insurance processing.

Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference.

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