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Insurance Benefits Claims Processor Jobs in Indiana

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Determine and apply appropriate health plan benefits and update claims for payment * Ensure timely ... claims processing functions Company Description Our Vision SIHO Insurance Services will be the ...

The CA takes the initial loss report from our client, sets expectations about the claims process, files the claim with the insurance company, notes the claim file as needed during the life of the ...

The CA takes the initial loss report from our client, sets expectations about the claims process, files the claim with the insurance company, notes the claim file as needed during the life of the ...

Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we ... Ability to interface with the insured and other stakeholders concerning claims related matters.

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Insurance Benefits Claims Processor information

What is the difference between Insurance Benefits Claims Processor vs Insurance Claims Adjuster?

AspectInsurance Benefits Claims ProcessorInsurance Claims Adjuster
CredentialsHigh school diploma or equivalent; certifications varyHigh school diploma; licensing or certification often required
Work EnvironmentOffice setting, processing claims dataField and office, investigating claims
Industry UsageUsed across insurance companies for processing claimsUsed for evaluating and settling claims
Primary FocusProcessing and verifying insurance benefits claimsAssessing damages and determining claim validity

Insurance Benefits Claims Processors primarily handle the administrative side of claims, focusing on data entry and verification. Insurance Claims Adjusters evaluate claims on-site or remotely, investigating damages and making settlement decisions. Both roles are essential in the insurance industry but differ in responsibilities and work environment.

What does an insurance benefits claims processor do?

An Insurance Benefits Claims Processor is responsible for reviewing, evaluating, and processing insurance claims submitted by policyholders. They verify information, determine coverage eligibility, and ensure that all documentation meets company and regulatory standards. Their work helps ensure that valid claims are paid promptly and accurately, while also identifying any errors or fraudulent activity. Claims processors often communicate with policyholders, healthcare providers, and other parties to gather necessary information or clarify details related to a claim.

What are some common challenges faced by insurance benefits claims processors and how can they be addressed?

Insurance Benefits Claims Processors often encounter challenges such as managing high volumes of claims, interpreting complex policy details, and ensuring compliance with regulatory requirements. Staying organized, using workflow management tools, and maintaining strong attention to detail can help address these issues. Regular communication with team members and ongoing training on policy updates also play a key role in overcoming these challenges. Collaboration with other departments, such as underwriting and customer service, is essential for resolving discrepancies and providing accurate claim resolutions.

What are the key skills and qualifications needed to thrive as an insurance benefits claims processor, and why are they important?

To thrive as an Insurance Benefits Claims Processor, you need strong attention to detail, analytical abilities, and a solid understanding of insurance policies, often supported by a high school diploma or relevant certification. Familiarity with claims management software, data entry systems, and standard office applications is typically required. Excellent communication, organizational skills, and problem-solving abilities help professionals excel when interacting with clients and resolving complex claims. These skills ensure accurate and timely claims processing, customer satisfaction, and compliance with industry regulations.
What are popular job titles related to Insurance Benefits Claims Processor jobs in Indiana? For Insurance Benefits Claims Processor jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Insurance Benefits Claims Processor jobs in Indiana look for? The top searched job categories for Insurance Benefits Claims Processor jobs in Indiana are:
What cities in Indiana are hiring for Insurance Benefits Claims Processor jobs? Cities in Indiana with the most Insurance Benefits Claims Processor job openings:
Infographic showing various Insurance Benefits Claims Processor job openings in Indiana as of August 2026, with employment types broken down into 100% Full Time. Highlights an 89% In-person, 2% Hybrid, and 9% Remote job distribution.

$48K - $55K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 5 days ago


Job description

Responsibilities:
To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments.
Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or continuous)
Review and analyze medical information (i.e. attending physician reports, medical records such as diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined.
Approval or denial on FMLA claims as per Insurance carrier, and employers guidelines
Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to US paid family law regulations.
Review claims for Not in good order cases, and work on securing missing documentations including employee, physician, or employer outreach.
Communicates clearly with the claimants and clients to set expectations on all aspects of claims process either by phone and/or written correspondence.
Reviews client critical deliverables, manages the overall workload, and second-level process escalation.
Determines benefits due, makes timely claims payments/approvals and adjustments for Workers Compensation, State Short Term Disability, and other disability offsets.
Refers cases as appropriate to team lead and clinical case management
Responsible for managing the day-to-day workload and first-level process escalation, and reviews processes for accuracy and timeliness where applicable in case of peer reviews.
Provide ideas to management on continuous improvement and service level management
Performs other duties or participates in special projects as assigned
Requirements:
1+ year of Disability/FMLA/PFL claims or insurance claims experience
Experience working with FINEOS
Working knowledge of medical terminology and documents, including APS, Diagnostic Tests, Imaging Tests reports
Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices mandatory
Excellent oral and written communication, including presentation skills
Strong Analytical, decision making, problem solving, and people management skills
Computer experience with keyboarding skills and proficiency in using software applications and packages including MS Office (Excel, Word, PPT)
Willingness to embrace change in a fast paced work environment
A strong desire to continuously learn and improve
Identify escalated cases and work with Team Leader to develop a plan to address key issues.
TCS Employee Benefits Summary:
• Discretionary Annual Incentive.
• Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.
• Family Support: Maternal & Parental Leaves.
• Insurance Options: Auto & Home Insurance, Identity Theft Protection.
• Convenience & Professional Growth: Commuter Benefits & Certification & Training Reimbursement.
• Time Off: Vacation, Time Off, Sick Leave & Holidays.
• Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.
Salary Ran ge: $48,000 - $55,000 per year