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Health Insurance Tpa Jobs (NOW HIRING)

Mercor

Health Insurance Expert - Compliance

New York, NY · Remote

$1.1K - $1.4K/wk

Health Insurance Expert Type: Contract Compensation: $1,150-$1,450 per completed task Location ... TPA, PBM, or managed care organization. * Background in claims processing, medical underwriting ...

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VAULT Strategies

Be Seen First

Senior Accountant

Scottsdale, AZ · On-site

$90K - $105K/yr

The ideal candidate understands the nuances of insurance accounting, healthcare claims activity, and TPA/captive structures , and can independently support external audits with minimal direction. Key ...

BC&L INC

TPA Services Manager

Austin, TX · On-site

Bachelor's degree in Business, Healthcare Administration, Insurance, or a related field; or equivalent work experience. * 3-5 years of experience in TPA operations, health insurance claims, or ...

Personify Health

Account Manager, TPA

Tempe, AZ · On-site

$65K - $85K/yr

Why This Role Matters Account Managers in TPA environments aren't just relationship coordinators ... Knowledge of health plan testing, regulatory compliance, and insurance plan administration mandates

Personify Health

Account Manager, TPA

Tempe, AZ

$65K - $85K/yr

Why This Role Matters Account Managers in TPA environments aren't just relationship coordinators ... Knowledge of health plan testing, regulatory compliance, and insurance plan administration mandates

Personify Health

Account Manager, TPA

Tempe, AZ

$65K - $85K/yr

Why This Role Matters Account Managers in TPA environments aren't just relationship coordinators ... Knowledge of health plan testing, regulatory compliance, and insurance plan administration mandates

Personify Health

Account Manager, TPA

Tempe, AZ · On-site

$65K - $85K/yr

Why This Role Matters Account Managers in TPA environments aren't just relationship coordinators ... Knowledge of health plan testing, regulatory compliance, and insurance plan administration mandates

VUMI Group

Director of TPA Relations

Miami, FL · On-site

POSITION SUMMARY The Director of TPA Relations is responsible for overseeing and optimizing the ... global health insurance, international assistance, or travel/expat medical programs. * Direct ...

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Showing results 1-20

All JobsHealth Insurance Tpa Jobs

Health Insurance TPA information

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$13

$21

$27

How much do health insurance tpa jobs pay per hour?

As of Jul 6, 2026, the average hourly pay for health insurance tpa in the United States is $21.04, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $23.80 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Health Insurance TPA (Third Party Administrator), and why are they important?

To excel as a Health Insurance TPA, you need a solid understanding of health insurance policies, claims processing, and regulatory compliance, often backed by a relevant degree in insurance, business, or healthcare administration. Familiarity with claims management software, policy administration systems, and industry certifications such as HIPAA compliance are typically required. Strong attention to detail, problem-solving abilities, and effective communication skills help build trust with clients and resolve issues efficiently. These competencies ensure accurate and timely claims processing, regulatory adherence, and high-quality customer service in a complex healthcare environment.

How does a Health Insurance TPA typically interact with insurance companies and healthcare providers on a daily basis?

A Health Insurance Third Party Administrator (TPA) acts as an intermediary between insurance companies, policyholders, and healthcare providers. On a daily basis, TPAs process insurance claims, coordinate with hospitals for cashless treatments, and verify documentation to ensure smooth claim settlements. They frequently communicate with insurers to clarify policy terms and resolve discrepancies, while also assisting healthcare providers in understanding claim requirements. This collaborative approach requires strong organizational and communication skills, as well as attention to detail.

What are Health Insurance TPAs?

Health Insurance TPAs, or Third Party Administrators, are organizations that process insurance claims or certain aspects of employee benefit plans for health insurance companies. They act as intermediaries between insurance providers, policyholders, and healthcare providers, ensuring that claims are processed efficiently and in accordance with policy terms. TPAs handle tasks such as claim adjudication, customer service, network management, and sometimes even policy administration. Their main role is to streamline operations for insurance companies and improve the experience for policyholders.

What is the difference between Health Insurance Tpa vs Health Insurance Claims Processor?

AspectHealth Insurance TpaHealth Insurance Claims Processor
RoleManages claims, customer service, and policy administration on behalf of insurersProcesses individual insurance claims, verifies documents, and approves or rejects claims
CredentialsTypically requires insurance or TPA-specific certificationsOften requires basic insurance knowledge and claims processing training
Work EnvironmentOffice-based, interacting with clients, insurers, and healthcare providersOffice or remote, focusing on data entry and claim verification
Industry UsageCommonly employed by third-party administrators in health insuranceUsed within insurance companies or third-party claims teams

In summary, a Health Insurance Tpa oversees claims management and customer service for insurers, while a Health Insurance Claims Processor focuses on the detailed processing and verification of individual claims. Both roles are essential in the health insurance industry but differ in scope and responsibilities.

More about Health Insurance TPA jobs
What states have the most Health Insurance Tpa jobs? States with the most job openings for Health Insurance Tpa jobs include:
What job categories do people searching Health Insurance Tpa jobs look for? The top searched job categories for Health Insurance Tpa jobs are:
Health Insurance TPA jobs near you
Infographic showing various Health Insurance Tpa job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 76% Full Time, 18% Part Time, and 5% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $43,763 per year, or $21 per hour.
Senior Business Analyst (Insurance/TPA background in Health, Annuity and Life)

Senior Business Analyst (Insurance/TPA background in Health, Annuity and Life)

Accord Technologies Inc.

Piscataway, NJ • On-site

$94K - $121K/yr

Contractor

Posted 14 hours ago

Be an early applicant

Job description

Senior Business Analyst (Insurance/TPA background in Health, Annuity and Life) 
Location: Piscataway, NJ (Hybrid 3 days a week from day 1)
Duration : 24 months.
No of position : 1
Position type: W2 contract.

Job Summary:
We are seeking an experienced Senior Business Analyst with deep expertise in Long-Term Care (LTC) insurance Third Party Administration (TPA) to join our dynamic team. The ideal candidate will have a thorough understanding of LTC policy terms, claim adjudication processes, and US regulatory requirements. This role requires excellent communication skills to collaborate effectively with cross-functional teams and stakeholders while adhering to Agile/Scrum methodologies. The Senior Business Analyst will play a pivotal role in bridging the gap between business needs and technical solutions, ensuring seamless delivery of LTC-specific systems and processes.

Key Responsibilities:

Domain-Specific Expertise and Analysis:

  • Analyze and interpret LTC insurance policy terms, benefit structures, claim adjudication guidelines, and compliance with US regulations.
  • Conduct in-depth gap analysis to identify inefficiencies and improvement opportunities in LTC claims adjudication and benefit management processes.
  • Assist in the development and validation of automated workflow solutions for LTC claims processing and benefit determinations.
  • Facilitate the integration and rigorous testing of LTC-specific claims systems and third-party vendor platforms.
  • Support customization and configuration of LTC policy rules to meet diverse client requirements.
  • Serve as the principal liaison for domain-specific training, documentation, and knowledge transfer to internal teams and external stakeholders.

Requirements Gathering and Documentation:

  • Elicit, analyze, and document comprehensive business, functional, and non-functional requirements specific to the LTC insurance domain.
  • Develop clear process flow diagrams, use cases, wireframes, and other visual aids to effectively communicate requirements.
  • Prepare detailed requirement traceability matrices to ensure alignment and coverage throughout the project lifecycle.

Stakeholder Communication & Agile Collaboration:

  • Facilitate effective communication between business stakeholders, product owners, and technical development teams to foster clear understanding and consensus on project requirements.
  • Lead stakeholder interviews, collaborative workshops, and requirement gathering sessions to capture evolving business needs.
  • Actively participate in Agile ceremonies including sprint planning, daily stand-ups, sprint reviews, and retrospectives.
  • Manage change requests with thorough analysis, documentation updates, and communication to all relevant parties.
  • Provide ongoing support, training, and user adoption strategies post-implementation.

Quality Assurance & Testing Support:

  • Collaborate with QA teams to define test cases informed by business requirements.
  • Support system integration testing and user acceptance testing phases.
  • Assist in defect triage, tracking, and resolution to ensure quality deliverables.

Project Management Support:

  • Contribute to project planning activities including scope definition, risk assessment, and timeline estimation.
  • Monitor project progress and provide status updates to leadership and stakeholders.

Continuous Improvement & Best Practices:

  • Stay current with industry trends, emerging technologies, and best practices in LTC insurance and business analysis.
  • Recommend process and system enhancements to improve operational efficiency, compliance, and customer satisfaction.

Qualifications:

  • Proven experience as a Business Analyst in the LTC Insurance TPA domain with strong knowledge of US regulations.
  • Demonstrated ability to interpret LTC policy language and claims adjudication processes.
  • Proficient in Agile/Scrum methodologies with experience working in functional and cross-functional teams.
  • Exceptional communication skills, capable of effectively engaging with technical teams and business stakeholders at all levels.
  • Strong analytical thinking with proficiency in creating process flows, use cases, and wireframes.
  • Experience supporting testing activities (system, integration, UAT).
  • Adept at managing requirements traceability, change management, and stakeholder expectations.
  • Ability to serve as a domain expert and trainer for LTC insurance processes
  • LOMA and CBAP certifications