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Insurance Claims Processing Jobs in Georgia (NOW HIRING)

Karna, LLC

$20 - $25/hr

Minimum of 5 years' experience in medical claims processing, including professional and facility ... Understanding of medical terminology, healthcare services, and insurance procedures (worker ...

KARNA LLC

$20 - $25/hr

Minimum of 5 years' experience in medical claims processing, including professional and facility ... Understanding of medical terminology, healthcare services, and insurance procedures (worker ...

Ova Technologies

Associate claims

Alpharetta, GA · On-site

$17.25 - $23.50/hr

Associate - Claims As an Associate - Claims, you will be responsible for handling, processing, and reviewing insurance claims in an accurate and timely manner. The role requires attention to detail ...

Home Depot

Manager - Claims

Atlanta, GA · On-site

Demonstrated supervisory and team management experience in the insurance claims field, with ability to mentor adjusters and implement efficient claims handling processes. Strong leadership abilities ...

AIG

Claims Adjuster- Bilingual

Atlanta, GA

$47K - $62K/yr

... processing services, and service contract underwriting. With over 20+ years of experience, we are ... Ability to interface with the insured and other stakeholders concerning claims related matters.

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Insurance Claims Processing information

Is claims processing a stressful job?

Insurance claims processing can be stressful due to tight deadlines, high workload, and the need for accuracy in evaluating claims. The role often requires strong attention to detail, communication skills, and the ability to handle difficult or emotional situations with claimants. However, workload and stress levels can vary depending on the employer and specific job environment.

What is insurance claims processing?

Insurance claims processing is the procedure by which insurance companies review, investigate, and settle claims made by policyholders. This process involves verifying the details of a claim, ensuring it meets the terms of the policy, and determining the appropriate payout or action. Claims processors handle documentation, communicate with claimants, and may work with other parties like adjusters or healthcare providers. The goal is to ensure claims are resolved efficiently, accurately, and fairly according to policy guidelines.

What are some common challenges faced in insurance claims processing, and how can new team members effectively manage them?

In insurance claims processing, new team members often encounter challenges such as handling high volumes of claims, interpreting complex policy language, and communicating effectively with policyholders and other stakeholders. To manage these challenges, it's important to develop strong organizational skills, stay detail-oriented, and proactively seek clarification when unsure about policy terms or procedures. Collaborating with experienced colleagues and taking advantage of ongoing training opportunities can also help new processors build confidence and efficiency in their daily tasks.

How to get a job as a claims adjuster with no experience?

To become a claims adjuster with no experience, focus on obtaining relevant certifications such as the Property and Casualty (P&C) license, which is often required. Gaining entry-level positions or internships in insurance companies can also help build industry knowledge and skills like communication and attention to detail, increasing your chances of starting a claims adjusting career.

What is the difference between Insurance Claims Processing vs Insurance Adjuster?

AspectInsurance Claims ProcessingInsurance Adjuster
CredentialsTypically requires a high school diploma or equivalent; certifications like CPCU or AIC are commonRequires a high school diploma; certifications like AIC or state licensing often needed
Work EnvironmentOffice-based, processing claims via computer systemsField and office work, inspecting damages and interviewing claimants
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Primary FocusReviewing and processing insurance claims efficientlyAssessing damages and determining claim validity and payout

While both roles are essential in the insurance industry, Insurance Claims Processing focuses on handling and managing claims paperwork, whereas Insurance Adjusters evaluate damages and determine claim settlements. Understanding these differences helps job seekers identify the right career path within the insurance sector.

What are the key skills and qualifications needed to thrive in Insurance Claims Processing, and why are they important?

To excel in Insurance Claims Processing, you need strong attention to detail, analytical abilities, and a foundational understanding of insurance policies or claims procedures, often supported by a high school diploma or associate degree. Familiarity with claims management software, databases, and sometimes industry certifications like AIC (Associate in Claims) is common. Effective communication, problem-solving skills, and the ability to manage stressful situations make someone stand out in this role. These competencies are critical for ensuring claims are processed accurately, efficiently, and in compliance with regulatory standards.

What does an insurance claims processor do?

An insurance claims processor reviews and evaluates insurance claims to determine coverage and payout amounts. They verify policy details, gather necessary documentation, and ensure claims are processed accurately and efficiently, often using specialized software. Strong attention to detail and knowledge of insurance policies are essential for this role.
What are popular job titles related to Insurance Claims Processing jobs in Georgia? For Insurance Claims Processing jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Processing jobs in Georgia look for? The top searched job categories for Insurance Claims Processing jobs in Georgia are:
What cities in Georgia are hiring for Insurance Claims Processing jobs? Cities in Georgia with the most Insurance Claims Processing job openings:
Insurance Claims Processing jobs near you

Claims Consultant

Tata Consultancy Service Limited

Stone Mountain, GA • On-site

$48K - $55K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 27 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

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