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Insurance Claim Representative Jobs in Tennessee

RAFTRx

Outside Sales Exemption

Nashville, TN · On-site

$150K/yr

... insurance claim processes. * Assist with local marketing efforts, such as distributing flyers and engaging with the community. * Collaborate with experienced sales representatives to improve your ...

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Insurance Claim Representative information

See Tennessee salary details

$6

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How much do insurance claim representative jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for insurance claim representative in Tennessee is $22.29, according to ZipRecruiter salary data. Most workers in this role earn between $16.15 and $26.20 per hour, depending on experience, location, and employer.

What does an insurance claim representative do?

An Insurance Claim Representative is responsible for evaluating insurance claims submitted by policyholders. They investigate the details of the claim, review documentation, and determine the validity of the claim in accordance with policy terms. Their duties often include interviewing claimants and witnesses, inspecting property damage, and negotiating settlements. The goal is to ensure fair outcomes for both the insurance company and the customer, while adhering to legal and regulatory requirements.

What are the key skills and qualifications needed to thrive as an insurance claim representative, and why are they important?

To thrive as an Insurance Claim Representative, you need a strong understanding of insurance policies, claims processing, and investigation, usually supported by a relevant degree or experience in the insurance industry. Familiarity with claims management systems, documentation software, and sometimes industry certifications like AINS or CPCU is important. Excellent communication, negotiation, and problem-solving skills help in effectively resolving claims and managing customer expectations. These abilities are essential to ensure accurate claim assessments, maintain customer trust, and support the financial health of the insurance provider.

How do insurance claim representatives typically collaborate with other departments during the claims process?

Insurance Claim Representatives frequently work closely with underwriting, legal, and field adjuster teams to ensure thorough evaluation and resolution of claims. They often consult with underwriters to clarify policy coverage, coordinate with adjusters for on-site assessments, and partner with legal teams on complex or disputed claims. This cross-functional collaboration ensures each claim is handled efficiently and accurately, providing both customers and the company with fair outcomes. Effective communication and teamwork are essential skills for success in this role.

Is it hard to be an insurance claim representative?

Being an insurance claim representative involves handling complex cases, requiring strong communication, attention to detail, and knowledge of insurance policies. The job can be demanding due to the need to evaluate claims accurately and manage customer interactions, but with proper training and experience, it becomes more manageable.

What are popular job titles related to Insurance Claim Representative jobs in Tennessee?

For Insurance Claim Representative jobs in Tennessee, the most frequently searched job titles are:

What job categories do people searching Insurance Claim Representative jobs in Tennessee look for?

The top searched job categories for Insurance Claim Representative jobs in Tennessee are:

What cities in Tennessee are hiring for Insurance Claim Representative jobs?

Cities in Tennessee with the most Insurance Claim Representative job openings:

Insurance Claim Representative jobs near you
Infographic showing various Insurance Claim Representative job openings in Tennessee as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $46,371 per year, or $22.3 per hour.

Insurance Verification Representative

Community Health Systems

Farragut, TN • On-site

$15 - $19/hr

Other

Posted 3 days ago

New

Community Health Systems rating

6.9

Company rating: 6.9 out of 10

Based on 276 frontline employees who took The Breakroom Quiz

454th of 898 rated healthcare providers

Job description

Insurance Verification Representative

The Insurance Verification Representative is responsible for accurately verifying patient insurance coverage, benefits, and eligibility to ensure proper reimbursement and prevent service delays. This role coordinates with physician offices, case management teams, and financial counseling to facilitate pre-certifications, authorizations, and patient financial obligations. The Insurance Verification Representative plays a key role in maintaining accurate patient account liability, minimizing denials, and improving revenue cycle efficiency.

Essential Functions

  • Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients, ensuring accuracy and completeness before services are rendered.
  • Coordinates with physician offices to obtain required pre-authorizations and pre-certifications, preventing reschedules or cancellations due to missing approvals.
  • Confirms patient coverage for procedures and treatments, documenting insurance details, policy limitations, and reimbursement expectations.
  • Initiates financial counseling for uninsured or underinsured patients, referring them to financial assistance programs or payment plan options.
  • Accurately documents and updates patient records, including pre-certification numbers, eligibility details, and authorization statuses.
  • Communicates effectively with patients and physician offices, providing clear information regarding insurance coverage, financial responsibilities, and payment expectations.
  • Ensures timely entry of pre-registration documents into the electronic health record (EHR) and forwards them to the appropriate department.
  • Maintains accurate department records, reports, and documentation, ensuring compliance with billing, regulatory, and facility policies.
  • Identifies and resolves insurance discrepancies, proactively addressing issues that could result in billing errors or claim denials.
  • Works collaboratively with case management, patient registration, and billing teams, ensuring seamless revenue cycle operations and optimized reimbursement.
  • Performs other duties as assigned.
  • Maintains regular and reliable attendance.
  • Complies with all policies and standards.

Qualifications

  • 0-2 years of experience in insurance verification, medical billing, or patient access in a healthcare setting required
  • 2-4 years of insurance verification experience in an acute care hospital or physician practice group preferred
  • Experience with electronic health records (EHR), insurance portals, and revenue cycle workflows preferred

Knowledge, Skills and Abilities

  • Strong knowledge of insurance verification, pre-authorizations, and patient financial services.
  • Proficiency in healthcare insurance terminology, including co-pays, deductibles, out-of-pocket costs, and covered services.
  • Ability to interpret and apply insurance policies and payer guidelines to verify eligibility and benefits accurately.
  • Effective communication and customer service skills, ensuring professional interactions with patients, physician offices, and insurance providers.
  • Strong organizational and time-management skills, handling multiple verification requests efficiently.
  • Proficiency in electronic health record (EHR) systems, payer websites, and insurance portals for eligibility verification.
  • Understanding of HIPAA regulations and patient privacy requirements when handling sensitive financial and insurance information.

Licenses and Certifications

  • CHAA - Certified Healthcare Access Associate preferred

Job Identification 162909

Job Category Finance and Accounting

Locations 10820 Parkside Dr, Knoxville, TN, 37934, US

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