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Insurance Claim Specialist Jobs (NOW HIRING)

FCCI Insurance Group

Claim Specialist

Birmingham, AL · On-site

$91K - $140K/yr

We are currently seeking an experienced commercial Claim Specialist to provide quality, cost ... Medical, Vision, Dental & Life Insurance * Employee Referral Bonus * Paid Volunteer Time * 401(k) ...

MEMIC

Associate Claim Specialist

Portland, ME · On-site

$60K - $70K/yr

About MEMIC At MEMIC, our mission is to make workers' compensation insurance better-through ... Claim Specialist I This position is in-person to start then transitions to hybrid. *Prior claims ...

MEMIC

Associate Claim Specialist

Portland, ME · On-site

$60K - $70K/yr

About MEMIC At MEMIC, our mission is to make workers' compensation insurance better-through ... Claim Specialist I This position is in-person to start then transitions to hybrid. *Prior claims ...

Cesna Group

Claim Specialist

Englewood Cliffs, NJ · On-site

$50K - $100K/yr

Review homeowners insurance claims to determine coverage eligibility based on policy * language, claim facts, and applicable laws. * - Review and validate claim payments and loss reserves recommended ...

MEMIC

Associate Claim Specialist

Portland, ME · Hybrid

$56K/yr

Are you looking to build a career in insurance claims management? Join MEMIC as an Associate Claim Specialist and be part of a team dedicated to providing fair, accurate, and compassionate claims ...

MEMIC

Associate Claim Specialist

Portland, ME · On-site

$56K/yr

Are you looking to build a career in insurance claims management? Join MEMIC as an Associate Claim Specialist and be part of a team dedicated to providing fair, accurate, and compassionate claims ...

CCMSI

Multi-Line Claim Specialist

Chicago, IL

$80K - $90K/yr

Multi Line Claim Specialist Location: Hybrid- Reporting to Chicago, IL Region Chicago-area ... Medical, Dental, Vision, Life, and Disability Insurance * Retirement plans : 401(k) and Employee ...

CCMSI

Multi-Line Claim Specialist

Chicago, IL · On-site

$80K - $90K/yr

Multi Line Claim Specialist Location: Hybrid- Reporting to Chicago, IL Region Chicago-area ... Medical, Dental, Vision, Life, and Disability Insurance * Retirement plans : 401(k) and Employee ...

CCMSI

Multi-Line Claim Specialist

Chicago, IL · On-site

$80K - $90K/yr

Multi Line Claim Specialist Location: Hybrid- Reporting to Chicago, IL Region Chicago-area ... Medical, Dental, Vision, Life, and Disability Insurance * Retirement plans : 401(k) and Employee ...

CCMSI

Workers' Compensation Claim Specialist

Irvine, CA

$85K - $95K/yr

Workers' Compensation Claim Specialist Location: Irvine, CA (reporting remotely) Schedule: Mon ... Medical, Dental, Vision, Life, and Disability Insurance * Retirement plans : 401(k) and Employee ...

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Insurance Claim Specialist information

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How much do insurance claim specialist jobs pay per hour?

As of Sep 10, 2026, the average hourly pay for insurance claim specialist in the United States is $23.50, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $25.72 per hour, depending on experience, location, and employer.

What does an insurance claim specialist do?

An Insurance Claim Specialist is responsible for processing and reviewing insurance claims to ensure accuracy and compliance with policy guidelines. They verify claim information, communicate with policyholders, healthcare providers, or other parties, and determine the validity of claims. Their role also involves resolving discrepancies, submitting claims for payment, and sometimes appealing denied claims. Insurance Claim Specialists play a key part in helping individuals and organizations receive the benefits they are entitled to under their insurance plans.

What are the key skills and qualifications needed to thrive as an insurance claim specialist?

To thrive as an Insurance Claim Specialist, you need in-depth knowledge of insurance policies, strong analytical skills, and attention to detail, often supported by a background in business, finance, or a related field. Familiarity with claims management software, CRM systems, and sometimes industry certifications such as AIC (Associate in Claims) is typically required. Excellent communication, negotiation, and customer service skills are vital for effectively managing client expectations and resolving disputes. These skills ensure accurate claim processing, regulatory compliance, and high customer satisfaction in a complex and fast-paced industry.

What are some typical challenges insurance claim specialists face when handling complex claims, and how can they effectively address them?

Insurance Claim Specialists often encounter challenges such as interpreting ambiguous policy language, managing high volumes of claims, and navigating disputes between policyholders and insurers. To address these, it is important to stay well-versed in policy details, maintain clear and empathetic communication with all parties, and collaborate closely with adjusters, underwriters, and legal teams. Leveraging strong organizational skills and ongoing training in industry regulations can also help specialists resolve issues efficiently and ensure fair outcomes.

What is the difference between Insurance Claim Specialist vs Insurance Adjuster?

AspectInsurance Claim SpecialistInsurance Adjuster
CredentialsTypically requires insurance licensing, certifications like CPCU or AISRequires licensing, certifications such as AIC or CPCU
Work EnvironmentOffice-based, customer service, claims processingFieldwork, inspecting damages, assessing claims
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Comparison Search IntentYesYes

Insurance Claim Specialists primarily handle claims processing and customer communication within an office setting, focusing on documentation and policy details. Insurance Adjusters, on the other hand, often conduct field inspections to assess damages firsthand. Both roles require licensing and industry-specific certifications, but their work environments and daily tasks differ significantly.

Do I need a degree to be an insurance claim specialist?

An insurance claim specialist typically does not require a college degree, but employers often prefer candidates with a high school diploma or equivalent. Relevant skills such as knowledge of insurance policies, attention to detail, and experience with claims processing or customer service are important, and some roles may require industry certifications like the Certified Claims Professional (CCP).
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Insurance Claim Specialist jobs near you
Infographic showing various Insurance Claim Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 20% Part Time, and 6% Contract. Highlights an 85% Physical, 1% Hybrid, and 14% Remote job distribution, with an average salary of $48,885 per year, or $23.5 per hour.

GIRMC Insurance Claim Specialist

Grand Island, NE • On-site

Bryan Health
Health Care and Social Assistance • 5 - 10K employees
Learn more about Bryan Healthexternal

Full-time

Posted 7 days ago

Bryan Health rating

6.9

Company rating: 6.9 out of 10

Based on 123 frontline employees who took The Breakroom Quiz

Job description

GENERAL SUMMARY:
Ensures accurate and timely reimbursement by reviewing, processing, and resolving medical claims in accordance with payer requirements and billing guidelines. Identifies and corrects claim issues, performs follow-up on unpaid or denied accounts, and documents actions to support resolution. Communicates with payers and internal teams to clarify requirements, address discrepancies, and facilitate account resolution. Applies revenue cycle knowledge and problem-solving skills to improve claim accuracy and support overall financial performance.
PRINCIPAL JOB FUNCTIONS:
  1. *Commits to the mission, vision, beliefs and consistently demonstrates our core values.
  1. *Reviews claims to ensure accurate and complete patient, insurance, and billing information prior to submission.
  1. *Identifies and resolves claim edits, rejections, and denials using established payer guidelines and internal processes.
  1. *Submits claims and performs follow-up on outstanding accounts through payer portals, phone, or other communication methods.
  1. *Analyzes Explanation of Benefits (EOBs), remittance advice, and account activity to determine appropriate actions, including corrections, rebills, or appeals.
  1. *Investigates account discrepancies and collaborates with internal teams to resolve coding, billing, or system issues.
  1. *Communicates with payers, patients, and other stakeholders to obtain necessary information and facilitate account resolution.
  1. *Documents all account activity, communications, and status updates clearly and accurately within billing systems.
  1. *Assists with credit balance review and resolution, including adjustments, recoupments, or refunds as appropriate.
  1. *Monitors assigned work queues and accounts to meet productivity, quality, and timeliness expectations.
  1. Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.
  1. Participates in meetings, committees and department projects as assigned.
  1. Performs other related projects and duties as assigned.

EDUCATION AND EXPERIENCE:
High school diploma or equivalent required. One (1) year of healthcare revenue cycle, medical billing, or accounts receivable experience required. Must be at least 19 years of age to witness legal consents.

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