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Insurance Claims Associate Jobs in Springfield, MA

IFG Companies

Claim Assistant

Hartford, CT · On-site

$50K - $52K/yr

The role of a CA is to assist in the claims process, which can include tasks such as data entry ... Training in the new loss set up process by Claim Associate. * Assisting with gathering information ...

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CT Litigation Associate Attorney

East Hartford, CT · On-site

$70K - $85K/yr

... claims. * Develop and implement litigation strategy, review and approve pleadings, discovery ... Vision insurance Work Location: In person

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Insurance Claims Associate information

See Springfield, MA salary details

$13

$20

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How much do insurance claims associate jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for insurance claims associate in Springfield, MA is $20.91, according to ZipRecruiter salary data. Most workers in this role earn between $17.02 and $22.98 per hour, depending on experience, location, and employer.

What are the main challenges insurance claims associates face when managing multiple claims simultaneously?

Insurance Claims Associates often handle numerous claims at once, which can be challenging due to varying complexities, tight deadlines, and the need to maintain accuracy. Balancing thorough investigations with efficient processing is crucial, as is clear communication with clients, adjusters, and other stakeholders. Strong organizational skills and the ability to prioritize urgent tasks help Associates manage their workload effectively while ensuring customer satisfaction and compliance with company policies.

What are the key skills and qualifications needed to thrive as an insurance claims associate?

To thrive as an Insurance Claims Associate, you need strong analytical skills, attention to detail, and a foundational knowledge of insurance policies, typically supported by a relevant degree or prior experience in insurance or customer service. Familiarity with claims management software, document management systems, and sometimes industry certifications like AIC (Associate in Claims) are often required. Excellent communication, negotiation, and problem-solving skills help in managing client interactions and resolving disputes efficiently. These abilities ensure accurate claims processing, customer satisfaction, and compliance with regulatory standards.

What does an insurance claims associate do?

An Insurance Claims Associate is responsible for processing and evaluating insurance claims submitted by clients. Their main duties include reviewing claim forms, gathering necessary documentation, assessing the validity of claims, and communicating with policyholders, adjusters, and other parties involved. They ensure that claims are handled efficiently and accurately, following company policies and regulatory guidelines. Claims Associates play a key role in providing customer service and resolving issues related to claims. Their work helps determine the amount of compensation or coverage due to clients.
What are the most commonly searched types of Insurance Claims jobs in Springfield, MA? The most popular types of Insurance Claims jobs in Springfield, MA are:
What are popular job titles related to Insurance Claims Associate jobs in Springfield, MA? For Insurance Claims Associate jobs in Springfield, MA, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Associate jobs in Springfield, MA look for? The top searched job categories for Insurance Claims Associate jobs in Springfield, MA are:
What cities near Springfield, MA are hiring for Insurance Claims Associate jobs? Cities near Springfield, MA with the most Insurance Claims Associate job openings:
Insurance Claims Associate jobs near you
Infographic showing various Insurance Claims Associate job openings in Springfield, MA as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 81% Physical, 1% Hybrid, and 18% Remote job distribution, with an average salary of $43,501 per year, or $20.9 per hour.

Pharmacy Claims Adjudication Specialist

Onco360

Hartford, CT • Remote

$26/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 19 days ago

Onco360 rating

7.7

Company rating: 7.7 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

21st of 111 rated pharmacies

Job description

We are seeking a Pharmacy Adjudication Specialist for our Specialty Oncology pharmacy.
As our company continues to grow, we strive to hire new team members with a passion for making a difference in our patient's lives.
Full-Time position may work remotely but MUST HAVE ACTIVE CONNECTICUT PHARMACY TECHNICIAN credentials from the State Board of Pharmacy.
Shift times between 8am and 8pm.
Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.
Starting salary from $26.00 an hour and up
Sign-On Bonus: $5,000 for employees starting before September 30th, 2026.
We offer a variety of benefits including:
  • Medical; Dental; Vision
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Company paid benefits – life; and short and long-term disability
Pharmacy Adjudication Specialist Major Responsibilities:
The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections
Pharmacy Adjudication Specialists at Onco360...
  • Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.
  • Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information..
  • Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.
  • Adjudicates pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and reviews claim responses for accuracy before accepting the claim.
  • Contacts insurance companies to resolve third-party rejections and ensures pharmacy claim rejections are resolved to allow for timely shipping of medications. Performs outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays
  • Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible)
  • Manages all funding related adjudications and works as a liaison to Onco360 Advocate team.
  • Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment.
  • Serves as customer service liaison to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted amount and claim and collects payment if applicable.
  • Documenst and submit requests for Patient Refunds when appropriate.
  • Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws.
  • Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.
  • Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
Pharmacy Adjudication Specialist Qualifications and Responsibilities...
  • Education/Learning Experience
    • Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication
    • Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience
  • Work Experience
    • Required: 2+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience
    • Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience
  • Skills/Knowledge
    • Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills
    • Desired: Knowledge of Foundation Funding, Specialty pharmacy experience
  • Licenses/Certifications
    • Desired: Registration with Board of Pharmacy as required by state law; Certified Pharmacy Technician (PTCB)
  • Behavior Competencies
    • Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills

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