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Health Insurance Tpa Jobs (NOW HIRING)

Luminare Health

Business Application Owner - LH

Bachelor's degree in Business, Information Systems, Healthcare Administration, or related field. 5+ years of experience in the health insurance, TPA, or healthcare technology industry. Strong ...

Luminare Health

Business Optimization Architect - LH

$62.25 - $80.75/hr

Experience within healthcare, insurance, or a health insurance TPA environment. Strong experience developing business cases and value realization frameworks. Excellent executive communication and ...

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 ...

Wipro Limited

Head of TPA Operations

Avenel, NJ · On-site

$200K - $280K/yr

The ideal candidate will have deep expertise in health insurance payor operations and a proven track record of driving efficiency, accuracy, and proactive compliance in a TPA environment. Essential ...

BC&L INC

TPA Services Manager

Austin, TX

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

$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

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 +1

$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

$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

$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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Health Insurance Tpa information

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$13

$21

$27

How much do health insurance tpa jobs pay per hour?

As of Jul 27, 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 100% Full Time. Highlights an 67% In-person, and 33% Remote job distribution, with an average salary of $43,763 per year, or $21 per hour.
TPA and Systems Coordinator

TPA and Systems Coordinator

American Restoration Operations LLC

Union, NJ • On-site

Full-time

Medical, Dental, Retirement, PTO

Posted 4 days ago

Job description

Overview
The TPA and Systems Coordinator is responsible for supporting insurance estimating and third-party administrator (TPA) processes by ensuring accurate data entry, compliance, and documentation. This office-based role requires advanced computer proficiency, extreme accuracy, and strong organizational skills. It offers an exciting opportunity to make a meaningful impact by helping property owners recover after sustaining damage to their homes or businesses.

Key Responsibilities

  • Manage the operations portion of the job management system, overseeing job progression from start to finish, including authorizations, compliance tasks, paperwork, photos, certificates of completion, and related documentation.
  • Enter all job updates and required information into TPA programs.
  • Upload photos, documents, and insurance information needed for estimates to be reviewed and sent to insurance carriers with invoices.
  • Audit and prepare estimates in alignment with TPA guidelines prior to review.
  • Accurately enter daily drying logs into Moisture Mapper and MICA.
  • Support data entry of time sheets, daily schedules, and appointment reminders.
  • Maintain up-to-date knowledge of all required programs, including Xactimate, Symbility, Moisture Mapper, MICA, and DocuSketch.
  • Work independently to manage tasks, prioritize workload, and solve problems.
  • Meet deadlines and work effectively under time constraints.
  • Assist in updating, creating, and educating team members on TPA-related processes and procedures.

Requirements

  • Advanced computer skills with proficiency in Microsoft Word, Excel, and Outlook; ability to learn and operate new programs quickly.
  • Effective written and verbal communication skills.
  • Strong attention to detail with excellent data-entry accuracy.
  • High level of integrity and ability to collaborate effectively with team members.
  • Self-motivated, dependable, and able to work additional hours during emergencies as needed.

Experience

  • 3+ years of Xactimate experience.
  • 3+ years of experience working directly with insurance TPA programs.
  • 3+ years of experience with Moisture Mapper and MICA.
  • 2+ years of Symbility experience strongly preferred.
  • 3+ years of experience working with insurance TPAs (third-party program administrators).

Job Type

  • Full-time

Benefits

  • 401(k)
  • Dental insurance
  • Health insurance
  • Paid time off

Schedule

  • Monday to Friday

Ability to Report to:

  • Union, NJ 07083

Work Location

  • In person