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Health Insurance Tpa Jobs (NOW HIRING)

SISCO

TPA Sales Executive (Fully Remote)

Dubuque, IA · Remote

... independent TPA. Why SISCO? * "Privately Owned" does not mean private equity - Our family of ... insured ancillary benefits. Optional services include a suite of advocacy and population health ...

AIG

Complex Claims Director - TPA Oversight

Lenexa, KS · On-site

$104K - $125K/yr

Strong technical expertise interpreting insurance contracts. * In depth knowledge of claim handling ... your health, wellbeing and financial security-as well as your professional development-to bring ...

AIG

Complex Claims Director - TPA Oversight

Chicago, IL · On-site

$104K - $125K/yr

Strong technical expertise interpreting insurance contracts. * In depth knowledge of claim handling ... your health, wellbeing and financial security-as well as your professional development-to bring ...

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Health Insurance TPA information

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How much do health insurance tpa jobs pay per hour?

As of Jul 7, 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.

Regional Sales Director, TPA Solutions

Crumdale Specialty

Paoli, PA • Remote

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 5 days ago

Be an early applicant

Job description

About Crumdale Specialty

Crumdale Specialty is a diversified insurance firm providing custom, self-funded healthcare solutions to a limited distribution network of brokers, consultants, and agents nationwide. Ranked on the Inc. 5000 Fastest Growing Companies and Best Workplaces, we leverage industry expertise, superior talent, data analytics, and a disruptive mindset to manufacture, underwrite, and administer agile, transparent, and cost-saving solutions.

At Crumdale, people come first. We strive to make a positive impact on the people we serve. Our company culture is rooted in alignment, innovation, and integrity.

About the Job

As a Regional Sales Director, you will be a cornerstone of our growth strategy. This role demands a highly driven, organized, and strategic professional with a passion for sales, broker development, and consultative solution selling. You will be responsible for building strong broker relationships, managing a robust sales pipeline, and closing high-quality business aligned with our integrated health platform.

We’re looking for a driven, broker-focused sales leader who knows how to win in the self-funded health plan space, with a focus on positioning and growing our Third Party Administration (TPA) platform.

Requirements

Key Responsibilities

  • Drive regional revenue growth by developing and executing a strategic sales plan focused on TPA solutions within the broader health plan ecosystem
  • Cultivate and expand relationships within the limited distribution network of brokers, consultants, and agents
  • Identify, develop, and close new business opportunities while strengthening existing partner relationships
  • Educate broker partners on the full suite of health plan solutions, with an emphasis on TPA-led plan design and administration strategy
  • Serve as a trusted advisor to brokers and consultants by delivering data-driven insights and strategic plan design recommendations
  • Collaborate cross-functionally with underwriting, actuarial, operations, and leadership teams to deliver competitive, customized proposals
  • Lead finalist presentations, strategy meetings, and executive-level discussions with brokers and employer groups
  • Maintain a disciplined pipeline management process, providing accurate forecasting and sales reporting
  • Monitor regional market trends and competitor activity to proactively position solutions
  • Achieve and exceed assigned sales targets, growth metrics, and profitability goals
  • Ensure alignment with underwriting discipline and long-term profitability strategy
  • Represent Crumdale at industry events and broker functions to expand market presence
  • Uphold culture of alignment, innovation, and integrity

Qualifications

  • 5+ years of successful sales experience in self-funded health plans, TPA platforms, stop-loss, or employee benefits markets
  • Demonstrated success building and managing broker/consultant relationships
  • Proven track record of meeting or exceeding revenue and growth targets
  • Strong understanding of alternative funding, captives, cost-containment strategies, and TPA operations
  • Ability to articulate complex solutions in a consultative, value-driven manner
  • Experience navigating multi-stakeholder sales cycles and leading executive presentations
  • Strong pipeline management and CRM proficiency
  • Financial acumen with focus on profitability
  • Entrepreneurial mindset and ability to operate independently
  • Willingness to travel within assigned region

Benefits

At Crumdale, we strive to provide a comprehensive and supportive benefits package to ensure the well-being of our employees. Our benefits include:

  • Medical
  • Telemedicine
  • Dental
  • Vision
  • Life, AD&D, Disability
  • 401(k)
  • Flexible Time-off

Please note: Crumdale Specialty is not engaging with external recruitment agencies; please refrain from contacting us regarding this position.